Facts e Proc

RFP: Fraud Control Analytics Platform and Services
National Health Authority (NHA)

Government of India
REQUEST FOR PROPOSAL (RFP)
“Selection of an agency to design, develop, implement,

operate and maintain Fraud Control Analytics Platform for
National Health Authority”
RFP Number: S-12013/2018-19/49/Finance

Date of Publishing RFP: 04/09/2019
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Disclaimer
The information contained in this Request for Proposal (RFP) Document is being provided to
select limited number of Service Providers/agency on the terms and conditions set out in this
Tender.
This is a Limited Tender, being issued to the participants found eligible under the EoI for Fraud
Control Analytics Platform and Services for NHA. Other participants are not permitted to
participate in this RFP.
The purpose of this Tender Document (hereinafter called RFP: Request for Proposal) is to
provide eligible interested parties with information that may be useful to them in making their
technical and financial offers pursuant to this RFP. This RFP includes statements, which reflect
various assumptions and assessments arrived at by the NHA (National Health Authority) in
relation to the Project. Such assumptions, assessments and statements do not purport to
contain all the information that each Bidder may require. This RFP may not be appropriate for
all persons, and it is not possible for the NHA, its employees or advisors to consider the
investment objectives, financial situation and particular needs of each party who reads or uses
this RFP. The assumptions, assessments, statements and information contained in the RFP
Document may not be complete, accurate, adequate or correct. Each Bidder should, therefore,
conduct its own investigations and analysis and should check the accuracy, adequacy,
correctness, reliability and completeness of the assumptions, assessments, statements and
information contained in this RFP Document and obtain independent advice from appropriate
sources.
Information provided in this RFP to the Limited set of Bidders is on a wide range of matters,
some of which may depend upon the interpretation of law. The information given is not intended
to be an exhaustive account of statutory requirements and should not be regarded as a
complete or authoritative statement of law. The NHA accepts no responsibility for the accuracy
or otherwise of any interpretation or opinion on law expressed herein.
The NHA, its employees and advisors, make no representation or warranty and shall have no
liability to any person, including any Bidder under any law, statute, rules or regulations or tort,
principles of restitution or unjust enrichment or otherwise for any loss, damages, costs or
expenses which may arise from or be incurred or suffered on account of anything contained in
this RFP or otherwise, including the accuracy, adequacy, correctness, completeness or
reliability of the RFP and any assessment, assumption, statement or information contained
therein or deemed to form part of this RFP Document or arising in any way for participation in
this Bid Process. The NHA also accepts no liability of any nature, whether resulting from
negligence or otherwise howsoever caused, arising from the reliance of any Bidder upon the
statements contained in this RFP.
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The NHA may, at its absolute discretion, but without being under any obligation to do so, update,
amend or supplement the information, assessment or assumptions contained in this RFP
Document. The issue of this RFP Document does not imply that the NHA is bound to select or
appoint a Bidder, as the case may be, for the Project and the NHA reserves the right to reject
all or any of the Bidder or Bids without assigning any reason whatsoever.
The Bidders shall bear all costs associated with or relating to the preparation and submission
of its Bid including but not limited to preparation, copying, postage, delivery fees, expenses
associated with any demonstrations or presentations which may be required by the NHA or any
other costs incurred in connection with or relating to its Bid. All such costs and expenses will
remain with the Service Provider/agency and the NHA shall not be liable in any manner
whatsoever for the same or for any other costs or other expenses incurred by a Bidder in
preparation or submission of the Bid, regardless of the conduct or outcome of the Bidding
Process.
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Table of Contents
1. INVITATION TO PROPOSAL .............................................................................................................. 7
2. FACT SHEET AND RFP SCHEDULE ................................................................................................. 9
3. ABOUT US ......................................................................................................................................... 11
3.1. BACKGROUND ................................................................................................................................ 11

3.2. AB-PMJAY – KEY FEATURES ......................................................................................................... 11
3.3. ROLE OF GOVERNMENT OF INDIA/NHA ............................................................................................ 12
3.4. ROLE OF STATE GOVERNMENT/SHA ............................................................................................... 14
4. SCOPE OF WORK ............................................................................................................................. 16
4.1. PROJECT BACKGROUND ............................................................................................................... 16

4.2. BUSINESS REQUIREMENTS .............................................................................................................. 27
4.3. TIMELINES AND TERM OF CONTRACT............................................................................................. 35
4.4. SOLUTION REQUIREMENTS ............................................................................................................. 36
4.5. ADHERENCE TO STANDARDS ........................................................................................................... 40
4.6. DEPLOYMENT OF MANPOWER ......................................................................................................... 40
4.7. SECURITY OF INFORMATION AND DATA ............................................................................................. 41
4.8. KEY DELIVERABLES ........................................................................................................................ 41
5. INSTRUCTIONS TO BIDDERS .......................................................................................................... 43
5.1. OBJECTIVES OF THIS RFP............................................................................................................... 43

5.2. GENERAL ....................................................................................................................................... 43
5.3. AVAILABILITY OF RFP DOCUMENT ................................................................................................... 43
5.4. BID SECURITY/EMD ....................................................................................................................... 44
5.5. BID PREPARATION COSTS ............................................................................................................... 45
5.6. CONSORTIUM/SUB-CONTRACTING ................................................................................................... 45
5.7. DEBARMENT FROM BIDDING ............................................................................................................ 46
5.8. AUTHORIZED SIGNATORY AND AUTHENTICATION OF BIDS ................................................................. 46
5.9. LANGUAGE ..................................................................................................................................... 47
5.10. COMPLETE AND COMPLIANT RESPONSES ...................................................................................... 47
5.11. LATE BIDS .................................................................................................................................... 47
5.12. PROPOSAL SUBMISSION FORMAT .................................................................................................. 48
5.13. AMENDMENT OF THE RFP ............................................................................................................. 48
5.14. BID VALIDITY ................................................................................................................................ 48
5.15. RIGHT TO THE CONTENT OF PROPOSAL ......................................................................................... 48
5.16. DISQUALIFICATION ........................................................................................................................ 48
5.17. CONFIDENTIALITY ......................................................................................................................... 49
5.18. FRAUD AND CORRUPT PRACTICES................................................................................................. 49
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5.19. RIGHT TO TERMINATE THE PROCESS ............................................................................................. 50

5.20. CONFLICT OF INTEREST ................................................................................................................ 51
6. BID PROCESS ................................................................................................................................... 53
6.1. PRE-BID QUERIES .......................................................................................................................... 53

6.2. PRE-BID CONFERENCE ................................................................................................................... 53
6.3. RESPONSES TO PRE-BID QUERIES AND ISSUE OF CORRIGENDUM ..................................................... 53
6.4. SUBMISSION OF RESPONSE ............................................................................................................ 53
6.5. SELECTION OF BIDDERS.................................................................................................................. 55
7. EVALUATION PROCESS AND CRITERIA ....................................................................................... 56
7.1. EVALUATION PROCESS ................................................................................................................... 56

7.2. EVALUATION CRITERIA .................................................................................................................. 57
8. AWARD OF CONTRACT ................................................................................................................... 61
8.1. AWARD CRITERIA ........................................................................................................................... 61

8.2. LETTER OF AWARD ......................................................................................................................... 61
8.3. PERFORMANCE GUARANTEE ........................................................................................................... 61
8.4. CONTRACT SIGNING ....................................................................................................................... 61
8.5. FAILURE TO AGREE WITH THE TERMS AND CONDITIONS OF THE RFP ................................................ 62
9. PAYMENT TERMS ............................................................................................................................. 63
9.1. PENALTIES FOR DELAY IN GO-LIVE .................................................................................................. 66

9.2. SERVICE LEVELS AND PENALTIES ..................................................................................................... 66
10. ANNEXURE I: TEMPLATE FOR PRE-BID QUERIES .................................................................... 71
11. ANNEXURE II: PRE-QUALIFICATION ............................................................................................ 73
11.1. RESPONSE TO PRE-QUALIFICATION CRITERIA ................................................................................. 73

11.2. FORMAT FOR BANK GUARANTEE EARNEST MONEY DEPOSIT .......................................................... 73
11.3. FORMAT- UNDERTAKING (NO CONFLICT OF INTEREST) .................................................................... 74
11.4. FORMAT – SELF DECLARATION FOR NON-BLACK LISTING ................................................................. 75
12. ANNEXURE III: TECHNICAL PROPOSAL FORMAT ..................................................................... 76
12.1. PROFILE OF THE BIDDING FIRM ...................................................................................................... 76

12.2. RESOURCE DEPLOYMENT PLAN ..................................................................................................... 77
12.3. FORMAT- CV’S OF PROPOSED RESOURCES .................................................................................... 77
12.4. NO DEVIATION CERTIFICATE .......................................................................................................... 78
12.5. TOTAL RESPONSIBILITY ................................................................................................................ 79
13. ANNEXURE IV: COMMERCIAL PROPOSAL FORMAT ................................................................ 80
13.1. PROPOSAL COVER LETTER......................................................................................................... 80

13.2. COMMERCIAL BID FORMAT............................................................................................................. 81
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14. ANNEXURE V: FORMAT FOR PERFORMANCE BANK GUARANTEE ....................................... 83
15. ANNEXURE VI: SECURITY REQUIREMENTS ............................................................................... 86
16. ANNEXURE VII: INTEGRITY PACT ................................................................................................ 90
Table of Tables
TABLE 1: FACT SHEET AND RFP SCHEDULE .............................................................................................. 10
TABLE 2: PROJECT TIMELINES................................................................................................................... 36
TABLE 3: PILOT PHASE IMPLEMENTATION .................................................... ERROR! BOOKMARK NOT DEFINED.
TABLE 4: PILOT PHASE PAYMENT MODEL .................................................... ERROR! BOOKMARK NOT DEFINED.
TABLE 5: M ANPOWER REQUIREMENTS (PHASE 1) ........................................ ERROR! BOOKMARK NOT DEFINED.
TABLE 6: M ANPOWER REQUIREMENTS (PHASE 2) ........................................ ERROR! BOOKMARK NOT DEFINED.
TABLE 7: DELIVERABLES (PHASE 1) ........................................................... ERROR! BOOKMARK NOT DEFINED.
TABLE 8: DELIVERABLES (PHASE 2) ........................................................... ERROR! BOOKMARK NOT DEFINED.
TABLE 9: THREE COVER BID SUBMISSION ................................................................................................... 54
TABLE 10: PRE-QUALIFICATION CRITERIA.................................................... ERROR! BOOKMARK NOT DEFINED.
TABLE 11: TECHNICAL EVALUATION CRITERIA (TEC).................................................................................. 58
TABLE 12: TEC (RELEVANT EXPERIENCE) .................................................. ERROR! BOOKMARK NOT DEFINED.
TABLE 13: TEC (PROPOSED SOLUTION) ..................................................... ERROR! BOOKMARK NOT DEFINED.
TABLE 14: TEC (TECHNICAL PRESENTATION AND PRODUCT DEMO) ............................................................ 59
TABLE 15: TEC (PROPOSED RESOURCE EVALUATION- PHASE 1) ................. ERROR! BOOKMARK NOT DEFINED.
TABLE 16: TEC (PROPOSED RESOURCE EVALUATION- PHASE 2) ................. ERROR! BOOKMARK NOT DEFINED.
TABLE 17: FORMULAE FOR FINAL EVALUATION........................................................................................... 60
TABLE 18: PAYMENT MILESTONES ............................................................................................................. 63
TABLE 19: PENALTIES FOR DELAY IN GO-LIVE ........................................................................................... 66
TABLE 20: DEFINITIONS (SERVICE LEVELS) ................................................................................................ 67
TABLE 21: SERVICE LEVELS ...................................................................................................................... 70
TABLE 22: PRE BID QUERIES (BIDDERS INFORMATION) ................................................................................ 71
TABLE 23: FORMAT FOR PRE BID QUERIES ................................................................................................. 71
TABLE 24: PRE-QUALIFICATION COMPLIANCE .............................................. ERROR! BOOKMARK NOT DEFINED.
TABLE 25: BIDDERS PROFILE .................................................................................................................... 77
TABLE 26: CITATION FORMAT ..................................................................... ERROR! BOOKMARK NOT DEFINED.
TABLE 27: RESOURCE DEPLOYMENT PLAN ................................................................................................. 77
TABLE 28: CV FORMAT ............................................................................................................................. 78
TABLE 29: COMMERCIAL BID FORMAT ........................................................................................................ 82
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1. Invitation to Proposal
New Delhi
Date: 04/09/2019
The Government of India is committed to ensuring highest possible level of health and well-
being for all, through a preventive and promotional health care orientation in developmental
policies and universal access to good quality health care services without anyone having to
face financial hardship. To fulfill this vision, the Government of India conceptualized ‘Ayushman
Bharat – a flagship initiative that attempts to move away from sectoral and segmented approach
of service delivery to a comprehensive need-based healthcare service. Ayushman Bharat
adopts a two-pronged approach. Firstly, the creation of health and wellness centers to bring
health care closer to homes. Secondly, Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana
to protect poor and vulnerable families against financial risk arising out of catastrophic health
episodes. For focused approach and effective implementation of AB-PMJAY, an autonomous
entity, the National Health Agency was constituted. Established as a Society on 11th May 2018,
the agency was registered under the Society Registration Act, 1860. The National Health
Agency is reconstituted as the National Health Authority through a cabinet decision. Through
the decision, the National Health Agency has been dissolved and has been replaced by
National Health Authority (NHA) as an attached office to Ministry of Health & Family
Welfare. NHA provides overall vision and stewardship for design, roll-out, implementation and
management of AB-PMJAY in alliance with state governments. Inter-alia, this
includes, formulation of AB-PMJAY policies, development of operational guidelines,
implementation mechanisms, coordination with state governments, monitoring and oversight of
AB-PMJAY amongst other.
The objective of this limited RFP is to seek the services of an agency to design, develop,
implement, operate and maintain Fraud Control Analytics Platform and related services for
National Health Authority. This is a limited tender being issued to the participants found eligible
in the Expression of Interest phase of the project. The selection of the agency shall be done as
per Quality and Cost Based Selection method i.e. QCBS method as provided in this RFP.
Only the following organizations who have conducted the PoC at NHA and were observed to
be technically suitable by NHA are eligible to participate and submit their bids against this RFP.
No other organization shall be permitted to submit their response against this RFP. Only the
following organizations may apply through this RFP:
a. MFX Infotech Private limited
b. LexisNexis Risk Solution Division
c. SAS Institute India Private Limited

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d. Optum Global Solutions India Private Limited
The website for accessing the information related to this RFP is central public procurement
portal (CPPP) i.e. https://eprocure.gov.in/eprocure/app and PMJAY website -
www.pmjay.gov.in. Interested bidders are requested to submit their proposals on CPPP to the
“RFP” on or before the timelines as mentioned on CPPP.
Thank you and we look forward to receiving your proposal.
Warm regards
General Manager (IT)
National Health Authority
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2. Fact Sheet and RFP Schedule

S. No. Reference Description
1. RFP Number and Issuing S-12013/2018-19/49/Finance
Authority Chief Executive Officer, National Health Authority
2. Date of publishing of RFP 04/09/2019
3. Job Requirement To design, develop, implement, operate and
maintain Fraud Control Analytics Platform and
Services for National Health Authority
4. Method of selection Two stage process comprising of:
i. Technical evaluation, and
ii. Commercial Evaluation
The final selection shall be based on Quality
and Cost Based Selection method i.e. QCBS
method (70:30)
5. Name of purchaser Chief Executive Officer, National Health
Authority, acting on behalf of the President of
India.
6. Availability of RFP document RFP document is available on the following
websites-
a. Central public procurement portal i.e.
CPPP- www.eprocure.gov.in
b. PMJAY website - www.pmjay.gov.in
7. Date till which the RFP The bid proposal shall remain valid for 180
response/bid validity should be (one hundred and eighty) days from the last
valid date of bid submission.
8. Pre-Bid Queries Clarification must be requested on or before
09/09/2019
Bidders are required to send the
queries/clarification request in MS excel file in
soft copy (as detailed in annexure 1). The e-
mail address for requesting clarification is:
manu.shukla@nic.in
9. Pre-Bid Meeting Date & Time of pre bid meeting- 11/09/2019
02:00 PM onwards at the below address-
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S. No. Reference Description

National Health Authority, 9th floor, tower-1, LIC
Jeevan Bharti Building, Connaught Place, New
Delhi”
10. Bid submission The last date for submission of Proposal is on or
before 01/10/2019 02:00 PM The bidder’s
proposal need to be submitted online at
www.eprocure.gov.in on or before the last date
of submission.
11. Currency The bidder to state all costs in Indian Rupees only
(₹).
12. Late Bids Late bids i.e. bids received after the specified date
and time of receipt will not be considered
13. Earnest Money Deposit The Bidders shall submit, along with their bids, a
Bid security/ Earnest Money Deposit (EMD) as
per the details specified in section 5.4 of this RFP.
EMD needs to be submitted manually to NHA and
a scan copy to be uploaded on CPPP along with
the proposal.
14. Date, Time and venue for 03/10/2019 02:00 PM
opening of pre-qualification Venue for bid opening-
bids of all bidders National Health Authority, 9th floor, Tower-I, LIC
Jeevan Bharti Building, Connaught Place, New
Delhi”
15. Tentative date, time and venue Date- To be announced later.
for opening of commercial bids Venue-
of all bidders (only of the National Health Authority, 9th floor, Tower-I, LIC
bidders who have qualified in Jeevan Bharti Building, Connaught Place, New
the pre-qualification evaluation Delhi”
stage)
16. Date, Time of announcement of To be announced later
the selected bidder.
Table 1: Fact sheet and RFP Schedule
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3. About Us
3.1. Background
Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB PMJAY) is an attempt to move
from sectoral, segmented and fragmented approach of service delivery through various
National and State/UT schemes to a bigger, more comprehensive and better converged need-
based service delivery of secondary and tertiary care. Ayushman Bharat Pradhan Mantri Jan
Arogya Yojana (AB PMJAY) seeks to accelerate India’s progress towards achievement of
Universal Health Coverage (UHC) and Sustainable Development Goal - 3 (SDG3). It has the
potential to transform the healthcare landscape of India It will not only increase the efficiency
and reach, but will also provide financial health protection for most of the hospitalisation cost
thereby reducing out of pocket expenditure on health significantly but also help reduce Out of
Pocket Expenditure (OOPE) for hospitalizations. It will help mitigate the financial risk arising out
of catastrophic health episodes.
3.2. AB-PMJAY – Key Features

Targeting over 10 crore poor and vulnerable beneficiary families. For identification of
beneficiaries, AB PMJAY will use deprivation and automatic inclusion criteria for rural areas
and defined occupational categories for urban from Socio-Economic Caste Census 2011
(SECC). All beneficiaries covered under Rashtriya Swasthya Bima Yojana (RSBY) but not
included in eligible SECC beneficiary list will be automatically included.
Eligible families entitled for cashless treatment benefits up to ₹5 lakh per family per year (on a
family floater basis), for secondary and tertiary care hospitalization. They can avail of these
benefits at any (public or private) empaneled hospital across India (national portability).
No cap on Family Size to ensure all members of designated families specifically girl child and
senior citizens get coverage. Suggested to preferably make woman as the head of a family.
Beneficiaries encouraged to bring Aadhar or any other recognized government photo identity
for the purpose of identification. However, benefits will not be denied under the Scheme in
absence of Aadhar.
Institutional Arrangement:
At Centre, a dedicated National Health Authority (NHA), headed by a full- time
CEO, has been set up to facilitate implementation of AB PMJAY.
States/ UTs advised to implement through a dedicated entity, State Health
Agency (SHA). They can either use an existing Trust/ Society/ Not for Profit
Company/ State Nodal Agency (SNA) or set up a new entity to implement the
scheme.
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Responsibility of implementing AB PMJAY shall lie with States. They can choose preferred
mode of implementation which can be either through Insurance Companies, Trust or a mixed
approach.
States can implement their own schemes in Alliance with AB PMJAY.
A robust, modular, scalable and interoperable IT platform connecting NHA with SHAs and
beneficiaries to the designated private and public health providers is being developed.
Benefit package includes identified surgical, medical and day-care benefits of secondary and
tertiary nature. Procedures also include lifesaving and emergency treatments that primarily
account for catastrophic expenses for families.
Payment for treatment on package rate (defined by the Government in advance) basis. States
will have the flexibility to modify these rates as per guidelines.
Public hospitals will get additional funds through claim payments from Insurance Companies/
Trust for treatment provided to beneficiaries. They can use this fund to strengthen their facilities
and to provide incentives.
While ensuring user convenience, AB PMJAY would create robust safeguards to prevent
misuse/ fraud/ abuse by providers and users.
A well-defined Complaint & Public Grievance Redressal Mechanism, actively utilizing
electronic, mobile platform, internet as well as social media, will be put in place.
The ratio of contribution towards premium/cost between Centre and State will be 60:40 in all
States except North Eastern States & 3 Himalayan States where the ratio is proposed to be
90:10. In the case of Union Territories, the Central contribution of premium is proposed to be
100% for UTs without legislature, while it is proposed to be 60:40 for those with legislature.
Transfer of grant-in-aid as premium to the Insurance Company / actual cost to the Trust and
administrative funds to SHA to be made through dedicated escrow accounts.
3.3. Role of Government of India/NHA

Government of India, through NHA, shall provide assistance to States for the implementation
of AB PMJAY in either Trust mode, Insurance mode, or a combination of the Trust or Insurance
mode. In particular, the Government of India through NHA shall do the following:
a. Central share of grant-in-aid: Release of Central share of grant-in-aid either as
premium contribution (decided by competitive bidding) for Insurance Company
mode, to the dedicated escrow account, or as actual claim for Trust mode including
administrative expenses in a timely manner. Amount of Central share shall be the
lowest of premium or actual claim and national ceiling.
b. Fostering coordination for implementation of AB PMJAY in Alliance with State
schemes: Fostering coordination with States for implementation of AB PMJAY in
Alliance with State schemes which includes providing any support to SHAs as
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required. NHA will also coordinate with regulatory bodies including IRDAI and other
initiatives/ agencies /authorities for sectoral reforms on behalf of the AB PMJAY.
Database of beneficiaries: Providing database of eligible beneficiary families (AB PMJAY
database) to the States. In case State is covering a larger number of beneficiaries than AB
PMJAY under their own Scheme, they can use their own database, subject to an assurance by
the State that all AB PMJAY eligible families (as decided by their inclusion in SECC database)
have been included in the State database.
Operational Guidelines and Model Tender Document (MTD) for selection of Insurance
Company, Implementation Support Agency (ISA), and Third Party Administrators (TPAs):
Provide AB PMJAY operational guidelines and MTD and any possible modifications to it from
time to time to States, as guiding posts for implementation under the ambit of the policy and the
technology while providing requisite flexibility / discretion to the States (as per due process) to
optimally chalk out the activities related to implementation in light of the special conditions of
their own State/ UT. NHA will exercise general scrutiny on the tendering process carried out by
States/SHA.
National Portability: Laying down the process and terms for extending portability of benefits to
all AB PMJAY beneficiaries at any empaneled health care providers (public and private) across
India.
IT System and Technical Support: Provide a Central IT platform with functional modules for
identification of eligible beneficiaries, transaction and claim management and provision of all
services under AB PMJAY. This will include Grievance Redressal platform and national
helpline.
Packages and criteria for empanelment of health care providers: Provide list of packages along
with indicative rates for treatments under AB PMJAY. Criteria for empanelment of health care
provider under AB PMJAY will also be provided. These can be adapted to State-specific
situation as per defined process.
Awareness Generation: Enable beneficiaries (who are the primary audience of this Mission) to
receive correct information about entitlements, scheme benefits, empanelment and other key
details, by providing the States with standardized awareness generation materials for
dissemination, which can be adapted to local languages. Amongst the secondary audience
(media, general audience etc.), create positive news around AB PMJAY and position AB
PMJAY as a game changer in achieving Universal Health Coverage. NHA will also develop
communication and training material for other secondary audiences such as hospitals, Front
Line Workers etc. to prepare them in implementing the scheme.
Training and Capacity Building: Provide standard training manuals for stakeholders and support
the States in organizing training of trainers and other capacity building activities in the State.
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Review and monitor progress under AB PMJAY: Review the performance of the Scheme and
monitor it on a regular basis and issue necessary directions from time to time.
3.4. Role of State Government/SHA

State Government shall set-up State Health Agency (SHA) as a dedicated entity, under the
administrative control of State Department of Health and Family Welfare for implementation of
AB PMJAY. Preparedness of the States is more important than any other factor for the success
of AB PMJAY. In order to ensure the timely roll out of the scheme and effective implementation,
States are expected to perform the following:
a. Provide necessary approvals: Approvals for implementation of AB PMJAY and
budget commitment for State contribution for premium and for incurring the
administrative costs will be needed. Approval for expansion of the Scheme /Alliance
with existing State schemes, cost for which will be borne by the State, will also need
to be taken.
b. Signing of Memorandum of Understanding (MoU) with NHA: State/SHA will sign a
MoU to formalize the partnership with NHA for implementation of AB PMJAY.
Institutional structure at State (SHA) and at districts: Decision on setting up of a new State
Health Agency or identification of an existing agency, managing their own health insurance/
protection schemes, for implementing AB PMJAY. Appropriate staffing of to carry out its
functions effectively with respect to implementation. Similarly, setting up of District structures
responsible for implementing the scheme and monitoring at the District level is very important
for the success of the Scheme.
Data management: Availability of team at State/ SHA to manage the AB PMJAY data. If the
State has decided to expand AB PMJAY to more categories of beneficiaries then mapping of
AB PMJAY and State scheme beneficiaries will need to be carried out.
Decision on IT platform: State/SHA need to decide on the IT platform to be used for
implementation of AB PMJAY, Central IT platform or their own IT platform (following data
sharing guidelines). If using Central IT platform, decide on central hosting or State level hosting
(in case additional features or functionalities are required).
Awareness generation of the scheme and informing target beneficiaries (who are the primary
audience of this Mission) about their entitlements: The success of the scheme to a large extent
will depend on informing the beneficiaries about their entitlements, how to access the services,
and, channels for proving client feedback/grievance redressal. The awareness generation
process, adopting various methods, will need to be a continuous activity to be carried out by
the State. The States will also disseminate communication material to other secondary
audiences such as hospitals, Front Line Workers etc. to prepare them in implementing the
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scheme. They will also liaise with the local media in disseminating the salient features of the
scheme
Tendering process for selection of Insurance Company or Setting-up / Identification of a Trust:
For Insurance mode, carry out tendering process (based on MTD shared by NHA) for selection
of an Insurer and signing of contract upon selection. OR Setting up of SHA / Trust with requisite
capacities for implementation of AB PMJAY in Trust mode.
Empanelment of Health Care Providers: The responsibility for empanelment of health care
providers lies with the State Government/ SHA. The SHA may take support of Insurance
Companies, if applicable and / or required. All public hospitals (CHC and above) will be deemed
to be empaneled.
Timely release of funds (to Insurance Company or to Hospitals): For Insurance mode, release
premium to insurance company, through dedicated escrow account, in a timely manner as per
the defined guidelines. For Trust mode, timely claim payments to empaneled Health Care
Providers to be paid as per the defined guidelines.
Monitoring: Monitoring the scheme effectively is the most important function of SHA and it shall
set up a comprehensive monitoring system for AB PMJAY, which shall be integrated with IT
system through data for fraud/ abuse prevention and control.
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4. Scope of Work
The following is the envisaged scope of work under this RFP. It is clarified that the scope of
work is not exhaustive but indicative in nature and not limited to the scope provided here and
the agency shall undertake such other tasks, within the scope of the RFP, as may be necessary
to implement the scope and the project efficiently and effectively in order to achieve the desired
objectives.
4.1. Project Background

It is a well-known fact that world over health insurance schemes/ programs are prone to fraud,
abuse and leakages which not only impact the program financially but also often lead to
endangerment of people’s health. Therefore, it is important to prevent, detect and deter fraud
effectively through robust processes, trained manpower, timely action backed by state-of-the-
art IT systems.
The National Health Authority (NHA), the nodal agency for providing technical and managerial
oversight, has adopted zero tolerance approach to fraud and is setting up framework for anti-
fraud policies, procedures and IT enablement which shall be adopted by the State Health
Agencies (SHAs). To further strengthen Fraud Control measures being planned under the
scheme, it is envisaged that industry consultations are undertaken to understand best practices,
policies, procedures and IT solutions available for implementation in context of AB-PMJAY.
The key objectives which this RFP aims to achieve are as follows:
• Perform fraud and related analytics on Individuals, Entities, Networks through specialized
analytical solutions/ tools
• Predicting and detecting entity identity, fraud/ evasion patterns, revenue leakages minimizing
the “false positives”
• Support NAFU/ SAFU Departments in informed decision making, investigation, audit and other
related works (Recovery, follow up return defaulters etc.) by having more targeted data points
through analysis
• Risk based rating of entities to predict and deter future incidences/ evasions
• Integration with internal & external data sources
• Create robust solution which can handle large volume of data/ big data (increasing multifold
every year)
• Generation of real time alerts to different entities to enable timely investigation
• Provide a centralized repository to track and manage all suspect and fraudulent cases
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The fraud analytics solution is envisaged to be used by NHA and its key stakeholders within
NHA ecosolution. This solution will take in data from various internal and external sources,
transform the data and present the data in an analyzable capability (with slicing / dicing
capability). The solution shall also make data-based predictions, contain best suited models/
algorithms to identify and detect frauds while providing more effective data insights.
The Data Ingestion component is required to ensure that the case data obtained by the
respective IO is ingested into a central repository which can then enable a holistic view of the
data for further analysis. The data may be available in structured / semi-structured /
unstructured formats; in electronic / paper form; provided in a batch or iteratively; or some other
unforeseen scenario may also be
encountered during the course of investigation(s). The Fraud management solution should be
flexible enough to cater to case requirements.
Please Note:
The Implementing Partner (IP) has to follow Agile methodology through the entire project
lifecycle. In case, it has been missed for any section/ phase/ deliverable, it may be read
as Agile Methodology may be followed
4.1.1. What Constitutes Fraud

Fraud under the AB-PMJAY shall mean and include any intentional deception,
manipulation of facts and / or documents or misrepresentation made by a person or
organization with the knowledge that the deception could result in unauthorized financial
or other benefit to herself/himself or some other person or organization. It includes any
act that may constitute fraud under any applicable law in India.
In addition to the above, any act (indicative list below) that is recognized by different
provisions of the Indian Penal Code as fraud shall be deemed to be fraud under the AB-
PMJAY:
• Impersonation
• Counterfeiting
• Misappropriation
• Criminal breach of trust
• Cheating
• Forgery
• Falsification / Concealment
Human errors and waste are not included in the definition of fraud. ‘Errors’ are unintentional
mistakes during the process of healthcare delivery (like prescribing wrong medications to a
patient). ‘Waste’ refers to unintentional inadvertent use of resources (prescribing high cost
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medicines when generic versions are available). ‘Abuse’ refers to those provider practices that
are inconsistent with sound fiscal, business, or medical practices, and result in an unnecessary
cost to the AB-PMJAY, or in reimbursement for services that are not medically necessary or
that fail to meet professionally recognized standards for health care. It also includes beneficiary
practices that result in unnecessary cost to the AB-PMJAY. Whereas fraud is willful and
deliberate, involves financial gain, is done under false pretense and is illegal, abuse generally
fails to meet one or more of these criteria. The main purpose of both fraud and abuse is financial
and non-financial gain. Few examples of common health insurance abuse would be - excessive
diagnostic tests, extended length of stay and conversion of day procedure to overnight
admission.
4.1.2. Types of Fraud and who may conduct it

Fraud under AB-PMJAY may be conducted by either a beneficiary, a payer or a provider.
Each type of fraud is described in the table below.
Fraud Type Description
Beneficiary Fraud conducted by an eligible beneficiary of AB-NHPM or an
Fraud individual impersonating as a beneficiary.
Payer Fraud conducted by a staff or consultant of NHA or SHA or

Fraud personnel employed by any of the agencies contracted by the NHA
or the SHA directly or indirectly involved with ABPMJAY. This
could include but is not limited to Insurance Companies, Third
Party Administrators, Implementation Support Agencies, IT
solutions provider, and management, monitoring or audit agencies.
Provider Fraud Fraud conducted by any private or public health service provider
empanelled for providing services under AB-PMJAY.
Beneficiary fraud means fraud conducted by an eligible beneficiary of AB-PMJAY and

may include but not be limited to:
• Making a false statement of eligibility (falsifying membership status) to access
health services or knowingly allow impersonation/identity theft in own name by
another person to access health services
• Using their rights to unnecessary services by falsifying their health conditions;
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• Giving gratifications to service providers to provide excluded/uncovered

services;
• Engaging in a conspiracy with service providers to submit false claims;
• Receiving prescribed medicines and/or medical devices for resale
AB-PMJAY staff fraud means fraud conducted by a staff or consultant of NHA or SHA
or personnel employed by any of the agencies contracted by the SHA directly or
indirectly involved with the ABPMJAY. AB-PMJAY staff fraud may include but not be
limited to:
• Engaging in a conspiracy with beneficiaries and/or empaneled health facilities to
submit false claims for reimbursement;
• Manipulating beneficiary list/covered members list
• Empaneling ineligible providers or providers with dubious reputation
• Manipulating uncovered benefits into covered benefits;
• Suspending payments to health facilities to take personal advantage.
• Not taking action against complaints of fraud received against provider(s) or
those indulging in unethical practices
Provider fraud means fraud conducted by any private or public healthcare provider
empaneled for providing services under the AB-PMJAY. Provider fraud may include but
not be limited to:
• Getting empaneled through manipulation of records or service/facilities etc.
• Manipulating/fudging claims for services paid through state budget;
• Receiving a commission for referral to AB-PMJAY services and benefits;
• Collecting fees from beneficiaries;
• Giving beneficiaries an inappropriate referral in order to gain a particular
advantage;
• Diagnosis up coding (change of diagnosis code and/or procedure to a code of
higher rate);
• Cloning of claims from other patients (duplication of claims from other patients’
claims);
• Phantom billing (claim for services never provided);
• Inflated bills for medicines and medical devices (claims for medicines and/or
medical devices larger than the real costs);
• Services unbundling or fragmentation (claim for two or more diagnoses and/or
procedures that should be in one service package in the same episode or
separate claims for a procedure that should be submitted in one service package
in order to produce a larger amount of claims in one episode);
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• Repeated billing (claim repeated for the same case);

• Prolonged length of stay;
• Cancelled services (claim for services that are cancelled);
• Measures of no medical value (claim for measures taken inconsistent with
medical needs or indications);
• Deviation from the standard of care – claim for a substandard diagnosis and/or
a measure;
• Unnecessary treatment;
• Phantom visit (claim for patients’ false visit);
• Phantom procedures (claim for procedures never taken);
• Readmissions diagnoses and/or measures for one episode claimed for more
than one time, as if for more than one episode.
• Indulging or conniving to indulge in unethical practices not permissible under
guidelines of Medical Council of India/State Medical Council for medical
practitioners or Clinical Establishment Act or under any other law of land or
established medical norms, whether leading to patient harm, future health
endangerment.
A list of common triggers used in health insurance industry/government health insurance
schemes for detecting suspected fraudulent transactions was also shared during the
EoI process.
4.1.3. Shortlisting of Organizations and conducted PoC

Invitation for participation in Industry Consultation on Fraud Control under Ayushman Bharat-
Pradhan Mantri Jan Arogya Yojana of National Health Agency (NHA) was floated on the website
on 31st August 2018. 23 Organizations showed interest and submitted the requisite documents.
Based on the one-to-one consultations with the above organizations and their solution offerings
during the consultation, NHA shortlisted the following organizations to conduct Proof of Concept
for fraud control under PM-JAY:
I. MFX Infotech Private limited
II. LexisNexis Risk Solution Division
III. SAS Institute India Private Limited
IV. Optum Global Solutions India Private Limited
V. M/s Greenojo
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4.1.4. Broad Scope of Work

The broad scope of work of the Implementing Partner (IP) is provided below:
a. An IT solution (Fraud Analytics Control and Tracking System (FACTS)) for seamless
management of all transactions and tasks under all modules with tightly controlled
processes.
b. Providing services to design and develop a Fraud Analytics and Control and
Tracking Solution considering PM-JAY ecosystem, data from other agencies
external to PM-JAY and BI/ analytics of data with help of Intelligence tools
c. Planning, procurement, installation & commissioning of Software required for
successful implementation & operations of Fraud Analytics Control and Tracking
solution
d. Configuration and tuning of all the installed equipment and related software
e. Integration and testing of installed solutions / subsolutions / equipment / Software
f. Implementation, operations and maintenance of Fraud Control Analytics
Platform Solution for a period of 3 years after Go-Live of project
g. Design of models/ algorithms and continuous improvement including delivery of new
types of fraud analysis /risk scoring/ visualizations besides improvement in existing
models / algorithms
h. Ensuring security by design
i. Ensuring uninterrupted and best in class services to users and stakeholders
j. Work in close co-ordination with the PM-JAY, existing MSP of PM-JAY solution and
other entities/ stakeholders (as suggested by PM-JAY) involved in the Project
k. Training and capacity building
l. Ensuring secrecy and confidentiality of and not limited to model/ patterns/
algorithms/design parameters/software etc. and governed by Non-disclosure
agreement
m. Proper exit management
The focus areas in fraud analytics activities are as mentioned below:
a. Use wide range of fraud analytics tools and methodologies (Can be open source or
proprietary tools/ technologies/ solutions considering best fit solution) to understand
what happened (descriptive analytics), why did it happen (diagnostic analytics),
what will happen (predictive analytics), and what is required to make it happen
(prescriptive analytics) and semantic/ sentiment analytics based on a robust risk
based framework.
b. Perform fraud analytics on the structured and unstructured data of AB-PMJAY
solution (i.e. from various modules such as HEM,BIS, TMS, Call center, Grievance
etc.), and any other external sources (as and when either provided directly by NHA
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or through API by external agencies or available in public domain) for early detection
and prediction of non-compliance issues/ fraud as it becomes available
c. Generate Real Time Intelligence and BI reports and dashboards
d. Enable end-to-end verification to find out outliers and monitor high risk scenarios
based on effective classification of individuals, entities, segments, groups, clusters
etc.
e. Have a dynamic and flexible solution with ability to automatically learn from events,
feedback and results
f. Provide real time inputs and alerts during the investigation process at the State and
center level in more enhanced and effective manner
g. Provide insights and recommendations for policy formulation/ modification to plug
any loop holes and tighten procedures as may get highlighted during the analysis
h. Solutions’ capability to be offered as a service, which can be integrated with PM-
JAY core solution and support relevant workflows viz pre-AUTH/claim rejection,
investigation, medical audit etc.
i. 360 degree risk based scoring of entities (Provider, Beneficiary, PMAM, TPA,
CSC/VLE etc.)
j. Real Time Risk scoring of Transactions/ cases
k. Customized on demand Reporting Capability as per user needs
l. Demographic profiling of entities
m. Content/Visualizations/Infographics to showcase analytics being conducted/ Cases
identified for Leadership Reviews, Presentations etc
n. Provide Inputs for Research Papers and Policy briefs from a data Mining Perspective
as requested by NHA Team
o. Capacity building of End Users as specified by NHA to demo / showcase the
systems/ platforms/ analytical results/ techniques developed
p. The solution should support both OTP (One Time Password)/soft tokens and PKI
(Public Key Infrastructure) based user authentication technologies
4.1.5. Detailed Scope of Work of Fraud Analytics Control and Tracking System
(FACTS)
360* view of all suspect/confirmed fraudulent transactions/entities involved in
committing fraud under/around PMJAY with workflow enabled end to end tracking and
closure.
a. Provide a unified view of all the potential suspicious cases as well as the confirmed
fraudulent cases that are happening inside the PMJAY ecosystem.
b. Ability to ingest data from various sources:
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o TMS
o BIS
o HEM
o Call centre
o Grievance portal
o Any other fraud reported within PMJAY ecosystem (will be achieved through
Record entry page)
o Ad-hoc inputs either through a ingestion form or through API
o External data sources (through API)
o Data in public domain
c. Provide a holistic view in context to risk scoring of a particular entity including:
o Beneficiary
o Provider
o PMAM
o CSC/VLE
o CPD/PPD
o TPA/ISA/IC
o Treating doctor
o Specialty
o Procedure/Packages
o Others
d. Provide insight on entity level association/co-relation, accumulation and
aggregation, risk profiling and heat maps
e. Provide insight on the fraudulent or suspicious cases taking place in a particular
state/district/hospital/ treating doctor/PMAM, and drilling down to the lowest level of
granularity.
f. Provide a dashboard on the existing cases under investigation and cases closed by
the state to monitor state performance.
g. Provide an insight on the key utilisation trends around a particular package,
speciality
h. Provide a holistic view on the cases reported against a particular fraud scenario/set
of triggers in a particular geography correlated with a particular entity.
i. Provide capability to record fraud happening outside PMJAY systems but around
PMJAY e.g. fake recruitment rackets, collection of beneficiary data, issuance of fake
cards (not in BIS) etc.
j. Provide capability to trigger a course correction initiation/email to relevant team if
need be e.g. HEM, TMS or BIS team could be alerted/informed about suggested
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course correction arising out of new scenarios (this would help keep a record on
generation of such request, rest process need not happen inside FACTS).
k. Managing key investigation steps up
l. Keep up to date on the recovery of amount
m. Generate a standard template for : showcause, suspension, de-empanelment _ why
is this needed- we can create the template and they need to code this in the system
n. Interact with key systems for taking key actions :
o De-empanelment of hospital
o Blocking of cards
o Denial of transaction
o. Ability to initiate an investigation against a suspicious case tracking its activity at
each ode in investigation process managing SLAs and capturing the response of
the investigation and concluding the case as fraud/non-fraud. Key systems
envisaged :
o TMS
o BIS
o HEM
o Using Kaizala to push cases for medical audit/field investigation and
receiving response back via Kiazala only
p. Ability to generate alerts both at NAFU, SAFU, Provider, PPD, CPD, Hospital,
Beneficiary level against a particular entity or general purpose messages.
q. Inter-communication module among the entities on E-mail or other mechanism.
r. Ability to incorporate feedback and utilise the feedback for data enrichment.
s. Provide a business intelligence view for trend analysis using Top 10 entities by case
No. across the combination of:
o States
o Hospitals, treating doctor
o Districts
o Specialities
o Procedures
o Referral entity
o Approving entity
t. Ability to configure business rules and provide ad-hoc reporting feature to the
business user.
u. Ability to interact with BIS, HEM, TMS on real time basis for e.g. If a case is triggered
as suspicious then the same should be marked in TMS as suspicious case and
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should be released from CPD/PPD bucket and simultaneously if a case is marked

as fraud, then the recovery of the case should be initiated in TMS via FACTS.
v. Automatic pushing of cases to call centre based on fraud severity level.
w. Wallet consumption view for beneficiary (public link to be available on NHA website)
x. Compatibility with IRDAI-General Insurance Council Repository –for purpose of
common minimum data points, APIs for submission and consumption, standard
codes for different entities and type of fraud, category etc.
y. FACTS shall form the base of NHA Repository for all Govt. schemes as per
recommendation of Joint Working sub-group, hence should be configurable and
open to APIs.
z. Automatic pushing of cases to call centre based on fraud severity level so as to
initiate the case investigations on time
aa. Receiving real time data from Call centre regarding potential fraud/ suspect cases
bb. Customized On Demand Reporting System based on User Specifications which
provides ability to end use to generate a custom report based on specified
parameters
cc. Provide a view for auto suggestion of question sets on the screen of call centre
officials based on the nature & severity of suspicious case they are dealing with
dd. Provide a discussion forum on the portal for replying to queries or discussing best
practices by the stakeholders involved.
ee. The discussion forum will further feed to chatbots support on the portal for answering
user queries by the machine and will assist in developing an FAQ tab which will
contain common question/answer pairs to assist the portal users
ff. Provide capability to trigger a course correction initiation/email to relevant team if
need be e.g. HEM, TMS or BIS team could be alerted/informed about suggested
course correction arising out of new scenarios (this would help keep a record on
generation of such request, rest process need not happen inside FACTS).
gg. Leverage AI/ ML solutions to provide proactive insights on fraud
hh. Conduct Image, Text , Audio and Video Analytics to identify new patterns of recurring
fraud
ii. Creation of Content/Visualizations/Infographics to showcase analytics being conducted/
Cases identified for Leadership Reviews, Presentations etc
jj. Contribute to creation of Research Papers and Policy briefs from a data Mining
Perspective as requested by NHA Team
kk. Capacity building of End Users to demo / showcase the systems/ platforms/ analytical
results/ techniques developed as requested by NHA
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4.1.6. Solution Overview
* The above diagram depicts the solution overview with the existing IT solution for PMJAY (BIS,
HEM, TMS etc.) deployed by NHA However, NHA is currently envisaging a new IT solution for
PMJAY which may be implemented in near future. It is expressively clarified that the
Implementing partner shall provision all its services including but not limited to Data acquisition
and integration with the new PMJAY IT 2.0 (at its’ go-live) at no extra cost to NHA.
4.1.7. Obligations of NHA
NHA will be responsible for the following:
a. Provide necessary support to the Implementing Partner (IP), where ever required
for developing the fraud analytics models and use cases – This is ambiguous- What
support- we will provide hardware and help them in setting up access
b. Facilitate proper collaboration between the existing MSP and to be selected
Implementing Partner (IP), which may include making the documentation of the
solution available, training/ knowledge sharing sessions, etc.
c. NHA will ensure that data of the PM-JAY solution shall be provided to Implementing
Partner (IP) as per the defined intervals and as and when required by Implementing
Partner (IP)
d. Facilitating Implementing Partner (IP) to obtain data from other Departments/
Agencies (as and when required)
e. Providing necessary office infrastructure, space and other accessories for the
Implementing Partner (IP) resources at Delhi. The Implementing Partner (IP) needs
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to bring in requisite laptops/software etc. required for the project. It may be noted
that the resources will not be able to use any external devices on these laptops.
4.2. Business Requirements

4.2.1. Data Processing
a. The solution should have the ability to load data into the data warehouse.
b. The solution should have the ability to perform data processing tasks such as data
validation, data transformation, generation of quality reports, data standardization,
data enrichment, etc.
c. The solution should have the ability to interact with relational databases and non-
relational databases.
d. The solution should have the ability to interact with various file formats such as
XML/XBRL, CSV, and fixed format files etc.
e. The solution should be able to manage data of various types including Geospatial
and Temporal, normalized data and dimensional data and should be compatible with
HDFS (Hadoop Distributed File Solution)
f. The solution should have the ability to interact with externalized distributed file
solutions such as Hadoop Distributed File Solution and other NoSQL-type
repositories.
g. The solution should have the ability to interact with data types of a less structured
nature such as email, websites, social media, office productivity tools and content
repositories.
h. The solution should enable bulk acquisition and delivery of data.
i. The solution should enable both bulk loading and incremental loading of data.
j. The solution should enable event-based acquisition (time-based or data-value-
based).
k. The solution should have the ability to identify and extract modified data using facility
such as changed data capture (CDC).
l. The solution should enable a staging area which has a similar environment as the
internal PM-JAY source solution to enable CDC based replication between source
solution and staging. This may be used for bidirectional data transfer and integration
as well.
m. The solution should have the ability to capture all critical data and metadata using
CDC to enable near real time data transfer and integration.
n. The solution should enable reconciliation of data between source solutions and Data
Warehouse using captured metadata
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o. The solution should enable updation of original record with revised record keeping a
clear linkage between the original and revised record.
p. The solution should provide data services, which will act as the single data
processing service for data received through multiple modes.
q. In case the data file is not properly encrypted or there is any other security concern,
the file must be rejected and deleted. A status should be sent to the sender along
with the reason and file id present in the XML/XBRL header.
r. The solution should provide data to consuming applications by physical bulk data
movement between data repositories.
s. The solution should support data delivery across the range of latency requirements,
including scheduled batch delivery, streaming/near-real-time delivery, event-driven
delivery of data based on identification of a relevant event.
4.2.2. Data Analytics
Data Analytics enables identification of useful / actionable information for effective
decision making and investigation.
a. The solution should have the capability of performing advanced data analytics such
as clustering, classification, profiling, anomaly detection, predictive modelling,
scoring, regression, link prediction, co-occurrence grouping, similarity matching,
causal modelling and machine learning.
b. The proposed solution should accept text from commonly used text sources such as
ASCII text, Microsoft Word files, Adobe PDF files, Microsoft Excel files, XML/XBRL
Files.
c. The solution should support both statistical and rule based classification mechanisms
for categorization of text data.
d. The solution should have pre-configured libraries and features to identify and extract
entities such as names, persons, organizations and locations from text data.
e. The solution should have the capability of using natural language processing (NLP)
techniques to identify main topics of discussion and correlated topics.
f. The solution should create a web of linked data from internal data (Databases,
XML/XBRL etc.) and entities extracted from unstructured data.
g. The solution should support use of ontologies to define relationships, concepts and
areas of concern to organize knowledge.
h. The solution should provide an interface for adding and modifying ontologies.
i. The solution should identify relationships across multiple entities and entity types.
j. The solution should be capable of drawing inferences i.e. discovering new
relationships from linked data using automatic procedures based on ontologies.
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k. The solution should be able to provide an intelligent tool for searching individuals,
entities, addresses using common attribute and relational data (related party search).
l. The solution should enable user to filter the search results by selecting or deselecting
specific attributes.
m. The solution should be able to detect and present linkage between any two entities
n. The solution should be able to compute adjacency (whether there is a direct
connection from entity to another), reachability (whether two entities are connected
or not by way of either a direct or an indirect linkages) etc.
o. The solution should provide an interface for navigating through the related
information using the linkages.
p. The solution should be able to form network of entities on the basis of relevance of
relationships between entities in semantic web (individuals, entities, addresses etc.)
using user defined rules.
q. The solution should be capable of discovery of meaningful correlations, patterns and
trends by sifting through large amounts of data stored in repositories employing
statistical and mathematical techniques.
r. The solution should demonstrate near similar performance with growth in data
volume
s. The structured and unstructured data made available during the course of
investigation is to be loaded into the central data repository in standardized format(s).
One such format may be the POLE Framework (People, Objects, Location, and
Events) which allows creation of master/golden record for an entity and updating the
same with additional data obtained subsequently.
4.2.3. Reporting and Dashboards
The solution should publish standard reports with predefined frequency covering the
elements from various sources :
a. Including HEM, TMS, BIS, Grievance, Complaints etc.
b. Link analysis using visualization tools
c. Timeline chart / chronology of events
d. Text analytics
e. Real time dashboarding capabilities
f. Machine learning analysis including statistical analysis. e.g., neural networks,
decision trees, regression, anomaly detection, clustering, etc.
g. The solution should present performance indicators and dashboards to authorised
users
h. The standard reports and MIS should be parameterized to enable users to choose
the filters and ranges of their choice.
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i. The solution should enable users to download information in common formats such
as EXCEL,PDF etc.
j. The solution should enable designated users to develop a customised dashboard
k. The solution should enable authorised users in handling of multi-dimensional
analysis (i.e. slicing and dicing the data) with drill-down, drill-up and drill-across
facilities.
l. The solution should provide an interface to enable users to submit request for
execution of customised query.
4.2.4. Case Management
Case Management module assists the division in managing the life-cycle of the case. It
helps the cases offices by providing case related information and analysis reports for
effective assessment and investigation.
a. The solution should present case related information and analysis to authorized
users for further processing.
b. The solution should have the capability to prepare customized case as per specific
user requirements based on selection of information and analytical elements.
c. The solution should provide a web-based interface to show case related information
and analysis to authorized users for further processing.
d. The solution should enable the user to drill down into the detailed data.
e. The solution should enable the user to access uploaded or linked documents.
f. The solution should present results on analysis (mismatch analysis, standard
quantification methods, network analytics etc.) in pre-defined format.
g. The solution should present the network diagram showing relationships (if number
of nodes is within a range) in pre-defined format.
h. The solution should have the capability to present information such as entity
(Provider /Beneficiary/PMAM/ CSC/VLE etc.) details and related entities (Treating
doctor etc.), relationships, standard analysis, evaluations, etc.
i. The solution should enable authorized users to carry out various case related
activities such as search, modify linkages, make request for information, link
additional information/documents, conduct predefined analysis, request for
enhanced report, provide case feedback, prepare case report etc.
j. The solution should enable cross references of the terms used in the case reports
by providing hyperlinks of the terms used to standard dictionaries.
k. The solution should allow record and maintain the access history (for user defined
period) for every successful and unsuccessful login by the user.
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l. The solution should enable authorized users to search both structured and
unstructured data in the Data Warehouse. The coverage of search facility will
depend on the underlying privileges of the user.
m. The solution should enable authorized users to make request for information from
external agencies (financial institutions, Departments, Regulators etc.) with whom
data exchange mechanisms have been enabled.
n. The solution should enable authorized users to link additional information and
documents collected during the investigation.
o. The solution should provide an interface to enable authorized users to upload
information and documents related to a case in a predefined XML/XBRL format
p. The solution should enable authorized users to capture information related to a case
or investigation in standard template.
q. The solution should enable authorized users to download data in Excel or CSV for
carrying out customized analysis.
r. The solution should enable authorized users to support from other authorized users
for analysis support, investigation support from other authorized users.
s. The solution should enable authorized users to provide analysis support and
investigation support as per pre-defined process.
t. The solution should enable authorized users to reassign the case to other authorized
user as per pre-defined rules (based on functional requirement, jurisdiction,
supervisory hierarchy etc.)
u. The solution should enable authorized users to close case after taking approval of
appropriate approving authority as per predefined closure rules.
v. The solution should enable authorized users to provide case feedback as per
prescribed template. This feedback will be used to assess the effectiveness and
fine-tuning of models in Alert and Risk Management.
w. The solution should enable authorized users to develop and maintain online case
reports.
x. The solution should enable authorized users populate different sections of the report
by referring to different sections of the case.
y. The solution should enable authorized users to define the component of the case
report by selecting available case components as per requirements.
z. The solution should enable multiple users to work on the case while maintaining
distinction between users updating the information.
aa. The solution should enable authorized users to generate and print reports in PDF,
Excel and XML/XBRL in a pre-defined format.
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bb. The solution should enable authorized users to transmit the case or access to case
information to the selected recipient.
cc. The solution should enable authorized users to disseminate the report to single or
multiple users / user groups.
dd. The solution should enable authorized users to search the Data warehouse for
information
ee. The solution should ensure that the digital data in case is managed appropriately
and is in compliance to the e-Governance Standard for Preservation Information
documentation (eGov-PID) of Electronic Records published by MeitY.
ff. The solution should enable authorized users to know whether more than one user
is working on a case.
gg. The solution should enable networking of multiple users working on a case after
seeking consent of users or approval of prescribed authority.
hh. The solution should be able to send configurable notification to authorized users on
predetermined event or receipt of additional information related to the case.
ii. The solution should have the capability to assign cases to specific officers on the
basis of jurisdiction or specific allocation rule to enable effective utilization of
available resources.
jj. The solution should have the capability to provide flexibility to local supervisory
hierarchy in assignment of cases.
kk. The solution should have the capability to manage the lifecycle of the case to ensure
closure of issue and capture of feedback.
ll. The solution should enable linking of factual issues with the case for effective
analysis.
mm. The solution should capture the feedback on the various alerts.
nn. The tool should have features related to user management, role based access and
privileges and allow multiple users to work in parallel
4.2.5. Case Management
a. The solution should be capable of customizing the alert generating scenarios and
parameters for different entity categories on the basis of user defined definitions. It
should enable to frame new rules and augment existing rules.
b. The solution should enable authorized users to create and modify risk dimensions.
c. The solution should allow authorized users to submit a request for new type of alert
which will be executed after approval of designated authority.
4.2.6. Knowledge Management
a. Allow the users to search for specific case based on rights.
b. Allow the users to start discussion forums, respond in discussion forums etc.
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c. Allow creation of specific interest groups for closed group interaction.

d. Allow the users to search for documents based on taxonomy.
4.2.7. Web mining and Social Media analysis
a. Web mining module leverages open source information for improving compliance
b. The solution should be capable of crawling open source information
c. The solution should be capable of interactive filtering of search results
d. The solution should be capable of discovering trends and sentiments from open
source information.
4.2.8. Alert and Risk Management
Alert management solution facilitates management of alerts related to implementation
of a structured risk management approach.
a. The solution should be capable of generating real time/near real time alerts based
on implemented functionalities business rules and models.
b. The solution should be capable of development and management of keyword for
effective generation and management of alerts.
c. The solution should be capable of generating alerts based on fraud risk hypothesis
d. The solution should be capable of aggregation and assessment of alerts.
e. The solution should be capable of interfacing with the Case management solution
for assisting lifecycle of the case to ensure closure of issue and capture of feedback.
f. The solution should be capable of assessment of events, feedback and results to
assist in fine tuning the models.
g. The solution should be capable of generating alerts based on implemented
functionalities/models relating to text analytics, network analytics, automated rules
and advanced analytics.
h. The solution should be capable of classifying entities in different entity segment on
the basis of user defined definitions.
i. The solution should be capable of generating alerts based on information mismatch
between third party information and information in returns/forms.
j. The solution should be capable of generating transaction monitoring alerts e.g. high
value or frequency of transactions as compared to previous history.
4.2.9. Un-Structured data
Fraud Analytics Control and Tracking Solution should be able to ingest data from
unstructured sources. Unstructured data to be converted into semi-structured data for
ingestion, querying and analysis purposes.
a. Photographs, forged/fabricated documents, scanned copies of medical notes/
documents
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b. Other documents basis case requirements, including supporting documents,

medical notes, discharge summary, Laboratory reports etc.
c. Images of Hand written documents including in Vernacular languages
d. Medical images including but not limited to MRI, CT Scan, X-Ray etc.
e. Audio and Video Files
f. Free form Text and other unstructured data
4.2.10. Data Exchange
a. Enable streamlined process for all types of exchange (request based, spontaneous
and automatic)
b. Develop agreed protocol to ensure inter-operability of data and processes
c. Device mechanism to ingest and share data with other bodies like IRDAI, MCI etc.
d. The solution should enable authorized users to make request for information from
external agencies (Departments, Regulators etc.) with whom data exchange
mechanisms have been enabled.
e. The solution should recognize the identity and category of exchange partner
transmitting the file and process the file as per pre-defined rules.
f. The solution should have data loss prevention capabilities. The solution should
provide recovery / automatic checkpoint restart/resume features to continue file
transfer after any failure.
g. The solution should enable web services for invocation by trusted third party
applications
h. The solution should allow upload of data files for spontaneous and automatic data
exchange.
i. The solution should be able to invoke relevant web services with specific
parameters, on the solution of the exchange partner, if the same is enabled.
j. The solution should provide for internet security for transfer of files
k. The solution should support third party or self-sign certificates.
4.2.11. Artificial Intelligence/ Machine Learning
a. Solution should have the capability to identification common patterns in data using
Machine Learning algorithms.
b. Platform should have capabilities in building statistical/machine learning models
using Python, R, etc.
c. These may deploy capabilities of both supervised and unsupervised learning.
d. The model(s) are to be generated on the basis of learning/training data of PM-JAY
ecosystem
e. Machine learning analysis including statistical analysis. e.g., neural networks,
decision trees, regression, anomaly detection, clustering, etc.
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f. The solution should be capable of machine learning to assist in fine-tuning the

models from analysis of subsequent events, feedback and outcomes
4.2.12. PM-JAY Ecosystem suspicion reporting portal
a. Allow the users to register specific complaints/suspicion against PM-JAY entities like
Provider, beneficiary, PMAM etc.
b. The complaint/ suspicion received on the portal have to be processed as per the
business workflow through Case management module.
c. The information in the complaint should also be used as an input by the Alert
management system to generate case alert, if required
4.3. Timelines and Term of contract

a. The project will be for a duration of 3 (three) years, from the date of go-live,
extendable to a further period of 2 (two) years (one year at one time) at the discretion
of NHA. The decision of contract extension shall be solely at the option and
discretion of NHA and will be binding upon the agency.
b. Implementation of this project and project implementation timelines have been
formulated for effective implementation of the project which are detailed below-
Deliverables Deliverable Timeline
Project Initiation Project kick off 1. Kick off meeting presentation T+1 Week
Deployment of key 2. List of key personnel deployed, CVs
personnel and Attendance register
Submission of key Deliverables: T+2 Weeks
documents i. Submission of charter
ii. Submission of detailed project plan
Broad technical Deliverables: T+2 Weeks
architecture and BOM i. Design high level technical,
deployment, network architecture and
approval from NHA
ii. Discussion on BOM and approval
from NHA
Environment Setup of Development System report to NHA T+3 Weeks
Setup Environment
Setup of Staging System report to NHA T+4 Weeks
Environment
Setup of Test System report to NHA T+4 Weeks
Environment
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Setup of UAT System report to NHA T+4 Weeks

Environment
Setup of PROD System report to NHA T+4 Weeks
Environment
Requirement Requirements Analysis Requirement Signoff from NHA T+2 Weeks
Analysis Preparation and Requirement Signoff from NHA T+5 Weeks
submission of SRS and
System Design
Document
Fraud Analytics Fraud Analytics Triggers from API to SAFU T+5 Weeks
Triggers Triggers to SAFU
Analytics Solution UAT from NHA T+5 Weeks
development, unit
testing, integration
testing
Fraud Analytics Develop/Customization T+16 Weeks
Control and and integration of Case
Tracking System Management, Alert
(FACTS) management and
Workflow with PM-JAY
ecosystem
Audit certification Audit and certification T+18 Weeks
of FACTS Solution by
CERT-In
empaneled vendor and
3rd Party Audit Agency
(TPAA)
Sign off on FACTS signoff from NHA on Steady state of T+32 Weeks
the FACTS
BAU Business as Usual T+156 Weeks
(from T+ 18 to T+156
Weeks)
Table 2: Project Timelines
4.4. Solution Requirements

a. The solution architecture (to be designed by the agency) should essentially be a
multi–layered architecture built on the principles of services based architecture.
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Architecture is proposed to be highly decoupled, modular, scalable and an integrated

solution.
b. Access to the system shall be web-based
c. The entire solution should have flexible and scalable architecture with well-defined
presentation layer, business logic layer and centralized data source layer to support
the efficient handling of data and business logic, and enable streamlined delivery.
d. Bidders are required to submit their proposed solution architecture, as deemed fit by
them, in the technical bid.
e. The proposed solution should have capability to configure rules and workflows in the
system as per NHA requirement and can be changed without impacting business
continuity. Also to have capability to define automated approval process in proposed
system.
f. The functionalities and features of the solution should be granular, flexible, scalable
and modular enough for the administrators to enable or disable any particular
functionality, at any given time, as per the requirement, without the need for a
developer / code level change / custom UI change
g. Solution shall have a responsive design such that the portal UI can be rendered on
desktops and laptops without requiring a code change.
The agency shall provision for five environments –
Development environment,
Testing/UAT environment,
Pre-Production environment
Production environment
Training Environment
Bidder will deploy application and provide support to manage application in DR
environment also, based on mutually agreed SLAs.
The agency should use a software configuration management system to systematically
manage, organize and control changes in the documents, codes, and other entities during
the development. Also, provide necessary access to NHA.
4.4.1. Software and user acceptance testing

The agency shall assist NHA & its designated authority in successful completion of User
Acceptance Testing (UAT) of the system on the completion of the development work for
each phase.
NHA may appoint Third Party Agency (TPA) at its own cost to conduct the technical
reviews and audits of development work performed by the agency.
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NHA & its designated authority/ TPA (if any) shall conduct functional, security &
performance testing of the systems provided by the agency. NHA would be free to
conduct such testing at any stage in addition to testing being done by the agency.
The agency shall obtain sign-off from the NHA on the UAT after successful
implementation of all the changes/ recommendations received from NHA & its
designated authority/ TPA (if any).
The agency shall design the testing strategy including traceability matrix, test cases and
conduct testing of various components of the solution developed/customized/
configured.
The testing shall include joint testing and integration testing with all partner systems.
The system will have to undergo a comprehensive testing that shall include Unit Testing,
System Testing, Integration Testing, Performance Testing, and Load and Stress testing
etc. before Go-Live.
The agency shall obtain the sign-off from NHA on testing approach and plan. The
agency shall perform the testing of the solution based on the approved test plan,
document the results and shall fix the bugs found during the testing. The overall
responsibility of testing the system lies with the agency.
4.4.2. Manpower support
a. The bidders as a part of their project proposal shall have to submit a resource plan
for the number and type of resources, along with their experiences, who shall be
deployed on-site for implementation and O&M of the project for the entire project
period.
b. The selected Bidder shall deploy the team of resources for implementation,
operations and maintenance till the end of contract period/exit management phase.
The agency shall comply with the biometric attendance at NHA (if desired by NHA).
It shall be the responsibility of the agency to scale up the Operations & Maintenance
(O&M) team as and when required to confirm smooth project execution throughout the
duration (at no extra cost to NHA).
4.4.3. Performance testing
The agency shall carry out the performance testing activity (load/ stress/ volume testing)
on yearly basis to ensure that the application meets the required speed, flexibility,
scalability and stability requirements under the expected workloads and provide its
recommendations for improvement (if any).
4.4.4. Capacity Building
Agency shall be required to provide training to the end users associated with the usage
of the solution, to enable them to effectively operate and perform the relevant functions.
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Agency shall carry out a comprehensive training needs analysis and design the training
program accordingly.
The agency shall ensure a proper hands-on training/capacity building to end-users
(approx. 120 users) designated by NHA so as to make them well conversant with all the
functionalities, features and processes built in the Fraud Analytics Control and
Trancking System. It is mandatory for the agency to provide a minimum of 40 hours
of training to each of the end user i.e. NHA/SHA officials during a calendar year.
If 10% of users reports to NHA that the training provided to them was unsatisfactory or
less than satisfactory, then the agency would re-conduct the same training at no extra
cost.
Location of the training shall be NHA Office.
Agency shall design a calendar of training activities in consultation with NHA. The
calendar designed shall identify the type of training, topics to be covered and the details
on trainee, trainer and the venue.
Agency shall create necessary performance support material such as user manual, job
aids, online reference manual, frequently asked questions, training documentation,
assessments and other content etc.
4.4.5. Incident management and help desk
A helpdesk management should be in place wherein end-users are allowed to create a
ticket for any problem(pertaining to bidder deliverables or system/platform) faced by him
and same should be closed by the agency’s team after the resolution of the problem (As
per the SLA).
4.4.6. Exit and transition management
The responsibilities of the agency pertaining to exit management after the end of the
contract are as follows:-
a. The agency shall submit its structured and detailed transition and exit management
plan and submit the same to NHA for approval and sign-off
All risk during transition stage shall be properly documented by the agency and
mitigation measures shall be planned in advance so as to ensure a smooth transition
without any service disruption.
Replacement of key resources during exit management shall be subject to NHA
approval.
Service level ownership, during exit, shall belong to the NHA. The agency is required to
deliver the operations and maintenance activities during this phase and payments to the
vendor shall be applicable as per RFP
The agency shall ensure that a proper and satisfactory handover is made to the other
agency (in case transition is there). This shall include transfer of all assets (Hardware,
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Software and all the documents) in working conditions after inspection and approval of
NHA.
The agency shall ensure business continuity i.e. business as usual of the project during
exit management. The agency shall be in complete ownership of all scope related items.
The agency shall be released from the project once successful transition is completed
by meeting the parameters defined for successful transition
4.5. Adherence to standards

The agency for the solution development and its operations and maintenance shall also
adhere to the relevant guidelines and standards issued by CERT-IN, MeitY and
Government of India including the following –
a. Information Technology Act 2000 (revised 2008)
(http://www.meity.gov.in/content/information-technology-act)
b. CERT-In security guidelines for Indian Government websites (http://www.cert-
in.org.in/)
c. E-SAFE Guidelines for Information Security (http://egovstandards.gov.in/ )
d. e-Governance Standards for Preservation Information Documentation of e-Records
(http://egovstandards.gov.in/ )
e. e-Governance standards on Biometric standards (http://egovstandards.gov.in/ )
f. Guidelines for Indian Government Websites (http://egovstandards.gov.in/ )
g. Information security and data privacy policies of NHA (https://www.pmjay.gov.in/)
4.6. Deployment of Manpower

a. Agency to propose resources to be deployed on the project for both phases along
with the CV format as prescribed in annexure-3 at the time of on-boarding. Once the
resources are approved by NHA then only the same shall be deployed on the
project.
b. All resources deployed by the agency should be working with the agency and not a
fresh hire i.e. hired in the last 2 months from the effective date of contract.
c. Different profiles needs to be proposed against different roles.
d. All resources proposed by the bidder must be deployed on the project.
e. NHA does not encourage replacement of resources unless it has been explicitly
asked for by NHA. If however, due to some pressing needs, the agency proposes a
replacement of resource, the proposed resource shall have similar/ better profile as
compared to the resource being replaced with regards to Academic Profile, Relevant
Work Experience and Relevant Technical Expertise. The appointment of the
resource will be confirmed only once the Head- Fraud Control has judged the
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knowledge, acumen and skills of the replacement resource and is convinced of the
same. In case, the replacement resource is not found to be satisfactory, Agency will
need to find another replacement resource within 7 days . The replacement resource
and the resource transitioning out should have a minimum overlap of 3 weeks to
ensure continuity. Failure to deploy the resource in time shall invite penalty of 1%
(of Total contract value) for each week of delay
f. NHA shall reserve the right to interview resources proposed by the Bidder.
g. The resources proposed shall necessarily be Indian citizens.
h. The agency shall undertake necessary due diligence to ensure that the personnel
deployed have a high level of integrity and high standard of trustworthiness.
i. Bidders should note that, during any subsequent stages of this procurement, NHA
may ask for background check and/or security verification (Police verification) of
resources proposed by the Bidder and Bidders needs to comply with the same. This
is necessary considering the criticality of the Project.
j. The agency shall deploy team consisting of minimum of following members for the
project within fifteen (15) days of date of Signing of Agreement / receiving of LOI.
Failure to deploy the resources shall invite penalty of 1% (of Total contract value)
for each week of delay
4.7. Security of information and data

The information and data at NHA are sensitive and confidential in nature not only for the
government but also for the citizens. Any compromise of such information can have serious
implications. It is therefore imperative to ensure confidentiality and integrity of data and
transactions at various stages. The agency will be required to comply with the latest version of
the NHA’s information security and policy manual (refer section 4.8), or prevalent best practices
in information systems which will govern the security of information assets and operations at
NHA during the entire duration of the contract (including extensions, if any). The agency shall
also comply to detailed IT security requirements mentioned at annexure VI of this RFP.
4.8. Key Deliverables

The agency shall submit the following deliverables to NHA as part of an assurance to fulfil the
obligations under the contract of this RFP. The table given below may not be exhaustive and
agency is responsible to provide all those deliverables which may be specified in this RFP but
not listed here and those agreed by agency in response to any request from NHA.
Note-
a. All project deliverables will be subject to a review and approval process and will be
signed off by the NHA.
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Peer reviews will be held for business design and technical design documents, and code-
walkthroughs
4.8.1. Phase 1: Development and testing phase
Sl. Deliverable (Phase 1) Delivery time frame
No.
1. Performance Bank guarantee As defined in section 8
of the RFP
2. Detailed Project Plan including risk management plan, IT At on-boarding (T)
security plan and resource deployment plan for
development phase and operations and maintenance
phase.
3. IT hardware assessment At on-boarding (T)
4. Project status reporting, communication framework, As defined in section 4

periodic status reports etc. of RFP.
5. a) Functional requirement specification T + 5 weeks
b) System Requirement Specifications (SRS)
Document
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5. Instructions to Bidders
5.1. Objectives of this RFP
The National Health Authority (hereinafter to be referred as NHA), through this RFP, invites
Proposals from eligible firms shortlisted through the EoI Process (hereafter referred as
‘Bidders’) for selection of agency’s which can meet the evaluation criteria specified in this RFP
and deliver the scope. The project information and the broad scope of work is detailed in Section
4 of this RFP.
The following organizations are eligible to apply through this RFP:
a. MFX Infotech Privat limited
b. LexisNexis Risk solution Division
c. SAS institute India Pvt. Limited
d. Optum global solutions India private limited
5.2. General
a. While every effort has been made to provide comprehensive and accurate
information about requirements and specifications, bidders must form their own
conclusions about the solution needed to meet the requirements specified in the
RFP.
b. The requirements of the RFP shall prevail over any information in the Bid. However,
all information supplied by the successful bidder will be treated as contractually
binding on the bidder.
c. This RFP supersedes and replaces any previous public documentation and
communications, and bidders should place no reliance on such communications.
d. No commitment of any kind, contractual or otherwise shall exist unless and until a
formal written contract has been executed by or on behalf of NHA.
e. NHA may cancel this bid process at any time prior to a formal written contract being
executed by or on behalf of NHA.
f. This RFP document is non-transferable.
g. The RFP should not be used to market the bidder’s product or services.
5.3. Availability of RFP Document

The Bid document can be downloaded for free from https://eprocure.gov.in/cppp/ and
https://pmjay.gov.in . The RFP document is available for download on all days and 24 x 7 till
the last date of submission of bids.
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5.4. Bid Security/EMD

a. The Bidders shall submit, along with their bids, a Bid security/ Earnest Money Deposit
(EMD) for an amount of ₹ 5,00,000 (INR Five Lacs Only) as bid security fee in the form of
a bank guarantee issued by any nationalized or scheduled commercial bank (of India) in
the format provided in Annexure II, section 11.2. The bidders may also submit bank
guarantee in the form of account payee demand draft also.
b. The bid security/ EMD shall be submitted in a separately sealed envelope. Bids submitted
without the EMD, or without adequate EMD, will be liable for rejection without providing
any opportunity to the bidder concerned.
c. EMD in any other form will not be accepted.
d. EMD must remain valid for at least 45 days beyond the final bid validity period and the
validity of the EMD should be extended in the event the last date of bid validity is extended.
No interest will be payable by the NHA on the EMD.
e. The EMD is required to protect NHA against the risk of Bidder’s conduct which may warrant
EMD’s forfeiture pursuant to the instances mentioned in clause (9) below.
f. EMDs of all unsuccessful Bidders will be returned, without interest, at the earliest after
expiry of the final bid validity and latest on or before the 30th day after the award of contract.
g. The EMD of the successful Bidder will be returned, without interest, upon submission of
Performance Bank Guarantee (of the amount and in the format specified in Annexure IV)
by the successful Bidder.
h. In case the EMD is not received within the stipulated deadline (provided in fact sheet) then
NHA reserves the right to forthwith and summarily reject the Proposal of the concerned
Bidder without providing any opportunity for any further correspondence by the concerned
Bidder.
i. Submission of EMD is applicable to all bidders except Micro and Small Enterprises (MSEs)
as defined in MSE Procurement Policy issued by Department of Micro, Small and Medium
Enterprises (MSME) or are registered with the Central Purchase Organization or the
concerned Ministry or Department.
j. The EMD may be forfeited:
If a Bidder withdraws the proposal or increases the quoted prices after opening
of the Proposal and during the period of Bid validity period or its extended
period, if any.
In case of a successful Bidder, if the Bidder fails to sign the contract in
accordance with the terms and conditions (including timelines for execution of
the Agreement) of this RFP or fails to furnish the Performance Bank Guarantee
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in accordance with the terms and conditions (including timelines for furnishing
PBG) of this RFP.
If the bidder is found indulging in any corrupt, fraudulent or other malpractice in
respect of the bid;
If there is a discrepancy between words and figures quoted by the bidder and
the bidder does not accept that the amount in words that would prevail over
amount in figures.
5.5. Bid Preparation Costs

a. The bidder is responsible for all costs incurred in connection with participation in this
process, including, but not limited to, costs incurred in conduct of informative and
other diligence activities, participation in meetings/discussions/presentations,
preparation of proposal, in providing any additional information required by NHA to
facilitate the evaluation process.
b. NHA will in no case be responsible or liable for those costs, regardless of the
conduct or outcome of the bidding process.
c. This RFP does not commit NHA to award a contract or to engage in negotiations.
Further, no reimbursable cost may be incurred in anticipation of award or for
preparing this RFP.
d. All materials submitted by the bidder will become the property of NHA and may be
returned completely at its sole discretion.
5.6. Consortium/Sub-Contracting
If required the bidder is allowed to utilize services of a third party for the following
activities:
I. System Administration
II. Maintenance of Software
The bidder will be responsible to oversee the work done by the third party all the time.
However the core business and functional activities should completely be executed by
the bidder these include, however not limited to:
I. Requirement gathering and understanding
II. Defining rules
III. Business rule configurations
IV. Overall project management
V. Executing the fraud triggers, Reports, MIS etc.
VI. Running day to day business activities
VII. Discussion with Key stakeholders
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Bidder will be required to intimate NHA about role segregation of their proposed third
party agency at the time of submitting RFP, however the overall responsibility of the
project and ownership will lie with bidder and no exception shall be allowed as regards
the milestone, deliverables and penalties.
Requirement for third party:
The bidder can only allowed to utilize services of the third party who meets the following
criteria:
I. A company incorporated in India under the Companies Act, 2013 or any other
previous
Companies Act, amendments from time to time
II. Implementation partner should not have been blacklisted or under declaration of
ineligibility for corrupt or fraudulent practices by Govt. of India/State
Government/Central PSU at the time of bid submission date.
III. It should a positive net worth
IV. Should have been operating for the last five years as on the date of publishing of
RFP notice
(including name change/impact of mergers or acquisitions).
5.7. Debarment from Bidding

a. A bidder shall be debarred if he has been convicted of an offence –
under the Prevention of Corruption Act, 1988; or
the Indian Penal Code or any other law for the time being in force, for causing
any loss of life or property or causing a threat to public health as part of
execution of a public procurement contract.
A bidder debarred under Section 5.7 (1) (a) above or any successor of the bidder shall not be
eligible to participate in this bidding process for a period not exceeding three years commencing
from the date of debarment.
5.8. Authorized Signatory and Authentication of Bids

The “Authorized Signatory” shall mean the one who has signed the Bid document. The
authorized signatory may be either the Principal Officer or the duly Authorized Representative
of the Bidder, in which case Bidder shall submit a power of attorney authorizing the person to
be authorized signatory or board resolution or letter of authorization.
The Authorized Signatory representing the Bidder shall digitally sign all bid document
suploaded on Central Public Procurement Portal (URL: https://eprocure.gov.in/cppp/) and
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attach a scanned copy of the physically signed and stamped Integrity Pact, Letter of
Authorization/board resolution/power of attorney and the EMD.
5.9. Language
The Proposal must be filled by the bidders in English language only. If any supporting
documents submitted are in any language other than English, translation of the same in English
language is required and should be duly attested by the Bidder. For purposes of interpretation
of the documents, the English translation shall govern.
5.10. Complete and Compliant Responses

a. Bidders are advised to study all instructions, forms, requirements and other
information in the RFP document carefully. Submission of the proposal shall be
deemed to have been done after careful study and examination of the RFP
document with full understanding of its implications.
b. The response to this RFP should be full and complete in all respects. Failure to
comply with the requirements of this paragraph may render the Proposal non-
compliant and the Proposal may be rejected. Bidders must:
Include all documentation specified in this RFP;
Follow the format of this RFP and respond to each element in the order
as set out in this RFP;
Comply with all requirements as set out in this RFP.
5.11. Late Bids

a. All Bidders are required to submit their bids (complete in all respects) within the time
and date as specified in fact sheet. The Bids received after the due date and the
specified time (including the extended period if any) for any reason whatsoever, shall
not be entertained. The Bids submitted by telex/telegram/fax/e-mail etc. shall not be
considered. No correspondence will be entertained on this matter. NHA shall not be
responsible for any delay or non-receipt/non-delivery of the documents. No further
correspondence on the subject will be entertained. NHA reserves the right to modify
and amend any of the above-stipulated condition/criteria depending upon project
priorities vis-à-vis urgent commitments.
b. Given that the bid submission to be made online, it is advised that the Bidder takes
all necessary precaution for the same, including submitting the Bid well in advance
to avoid any last minute hassles. The NHA shall not entertain any bids which could
not be submitted properly for whatsoever reasons.
c. NHA may, in exceptional circumstances and at its discretion, extend the deadline
for submission of proposals by issuing an addendum/corrigendum or by intimating
all bidders, in writing or through e-mail, in which case all rights and obligations of
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NHA and the bidders previously subject to the original deadline will thereafter be
subject to the deadline as extended.
5.12. Proposal Submission Format

The entire proposal shall be strictly as per the format specified in this RFP and any deviation
may result in the rejection of the RFP proposal. Refer Section 6.4 for the format for Proposal
Submission.
5.13. Amendment of the RFP

At any time prior to the deadline for submission of the proposals, NHA, for any reason, may
modify the RFP by amendment/corrigendum and it shall publish the same on the website. Such
amendments shall be binding on the Bidders. In case of such modifications, the bidders who
have submitted their responses, prior to such amendments, to the original invitation shall be
provided with an opportunity to modify or re-submit or withdraw their bids. Bidders are requested
to regularly visit the website and check for themselves regarding any addendum/corrigendum
issued to the RFP. NHA shall, in no way, be responsible for any lapse of information on part of
the concerned bidder(s) for non-checking the website for RFP related updates/information.
5.14. Bid Validity

Bids must remain valid up to 180 (One Hundred & Eighty) days from the last date of submission
of the Bids. NHA may request the Bidder(s) for an extension of the period of validity of the bids
which may suitably be extended post such requests. The validity of the EMDs as requested in
Section 5.4 should also be suitably extended if called upon to do so by NHA.
5.15. Right to the Content of Proposal

All bids and accompanying documentation of the bid proposal will become the property of NHA,
and will not be returned after opening of the bid proposals. NHA is not restricted in its rights to
use or disclose any or all of the information contained in the proposal and can do so without
compensation to the bidders. NHA shall not be bound by any language in the proposal indicating
the confidentiality of the proposal or any other restriction on its use or disclosure.
5.16. Disqualification
The Proposal is liable to be disqualified in, inter alia, any of the following cases or in case the
Bidder fails to meet the bidding requirements as indicated in this RFP:
a. Bid not submitted in accordance with the terms, procedure and formats prescribed
in this document or treated as non-conforming proposal;
b. During validity of the bid, or its extended period, if any, the Bidder increases its
quoted price after the submission of the bid;
The Bidder’s Proposal is conditional and has deviations from the terms and conditions of RFP.
The Proposal is received in incomplete form;
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The Proposal is received after the due date and time;

The Proposal is not accompanied by all the requisite documents;
The Proposal is submitted with lesser validity period;
The information submitted in the Technical Proposal is found to be misrepresented, incorrect
or false, accidentally, unwittingly or otherwise, at any time during the processing of the contract
(no matter at what stage) or during the tenure of the contract including the extension period, if
any;
The Commercial Proposal is enclosed within the technical Proposal or other Proposal;
5.17. Confidentiality
Information relating to the examination, clarification and comparison of the RFP shall not be
disclosed to any persons not officially concerned with such process until the process is over.
Undue use of confidential information related to the process by any firm may result in rejection
of its RFP.
5.18. Fraud and Corrupt Practices

a. The Bidders and their respective officers, employees, agents and advisers shall
observe the highest standard of ethics during the selection process. Notwithstanding
anything to the contrary contained in this RFP, the NHA shall reject a Proposal
without being liable in any manner whatsoever to the Bidder, if it determines that the
Bidder has, directly or indirectly or through an agent, engaged in corrupt practice,
fraudulent practice, coercive practice, undesirable practice or restrictive practice
(collectively the “Prohibited Practices”) in the selection process. In such an event,
NHA shall, without prejudice to it’s any other rights or remedies, forfeit and
appropriate the EMD and/or PBG, as the case may be.
b. Without prejudice to the rights of NHA under clause above and the rights and
remedies which the NHA may have under the Agreement, if a Bidder is found by
NHA to have directly or indirectly or through an agent, engaged or indulged in any
corrupt practice, fraudulent practice, coercive practice, undesirable practice or
restrictive practice during the selection process, or after the issue of the Letter of
Award (LOA) or the execution of the Agreement, such Bidder shall not be eligible to
participate in any tender or RFP issued by NHA during a period of 3 years from the
date such Bidder is found by NHA to have directly or through an agent, engaged or
indulged in any corrupt practice, fraudulent practice, coercive practice, undesirable
practice or restrictive practice, as the case may be.
c. For the purposes of this Section, the following terms shall have the meaning
hereinafter respectively assigned to them:
“Corrupt Practice” means
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i. the offering, giving, receiving, or soliciting, directly or indirectly, of anything of

value to influence the action of any person connected with the selection
process (for avoidance of doubt, offering of employment to or employing or
engaging in any manner whatsoever, directly or indirectly, any official of NHA
who is or has been associated in any manner, directly or indirectly with the
selection process or the LOA or has dealt with matters concerning the
Agreement or arising there from, before or after the execution thereof, at any
time prior to the expiry of one year from the date such official resigns or retires
from or otherwise ceases to be in the service of NHA shall be deemed to
constitute influencing the actions of a person connected with the selection
process); or
ii. save as provided herein, engaging in any manner whatsoever, whether during
the selection process or after the issue of the LOA or after the execution of
the Agreement, as the case may be, any person in respect of any matter
relating to the Project or the Award or the Agreement, who at any time has
been or is a legal, financial or technical consultant/adviser of NHA in relation
to any matter concerning the Project;
“Fraudulent Practice” means a misrepresentation or omission of facts or
disclosure of incomplete facts, in order to influence the selection process;
“Coercive Practice” means impairing or harming or threatening to impair or
harm, directly or indirectly, any persons or property to influence any person’s
participation or action in the selection process;
“Undesirable Practice” means
i. establishing contact with any person connected with or employed or engaged
by NHA with the objective of canvassing, lobbying or in any manner
influencing or attempting to influence the selection process; or
ii. having a Conflict of Interest; and
“Restrictive Practice” means forming a cartel or arriving at any understanding
or arrangement among the Bidders with the objective of restricting or
manipulating a full and fair competition in the selection process.
5.19. Right to Terminate the Process

a. NHA may terminate the RFP process at any time and without assigning any reason.
NHA makes no commitments, express or implied, that this process will result in a
business transaction with anyone.
b. This RFP does not constitute an offer by NHA. The bidder's participation in this
process may result in short listing the bidders.
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5.20. Conflict of Interest

a. The Bidder shall not have a conflict of interest that may affect the selection process
(the “Conflict of Interest”). Any Bidder found to have a Conflict of Interest shall be
disqualified. In the event of disqualification, the NHA shall forfeit and appropriate the
EMD, if available, as mutually agreed genuine pre-estimated compensation and
damages payable to the NHA for, inter alia, the time, cost and effort of the NHA
including consideration of such Bidder’s Proposal, without prejudice to any other
right or remedy that may be available to the NHA hereunder or otherwise.
b. NHA requires that the agency provides professional, objective, and impartial
services and at all times hold the NHA’s interests paramount, avoid conflicts with
other assignments or its own interests, and act without any consideration for future
work. The agency shall not accept or engage in any assignment that would be in
conflict with its prior or current obligations to other clients, or that may place it in a
position of not being able to carry out the assignment in the best interests of the
NHA.
c. Without limiting the generality of the above, the Bidder shall be deemed to have a
Conflict of Interest affecting the Selection Process, if:
The Bidder, or Associates (or any constituent thereof) and any other Bidder,
or Associate (or any constituent thereof) have common controlling
shareholders or other ownership interest;
Such Bidder or its Associate receives or has received any direct or indirect
subsidy or grant from any other Bidder or its Associate; or
Such Bidder has a relationship with another Bidder, directly or
through common third parties, that puts them in a position to have access
to each other’s information about, or to influence the Proposal of either or
each of the other Bidder; or
There is a conflict among this and other assignments of the
Bidder (including its personnel and other members, if any) and any
subsidiaries or entities controlled by such Bidder or having common
controlling shareholders. The duties of the agency will depend on the
circumstances of each case. While providing services to the NHA for this
particular assignment, the agency shall not take up any assignment that by
its nature will result in conflict with the present assignment; or
A firm hired to provide similar services for the preparation or
implementation of a project, and its Members or Associates, will be
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disqualified from subsequently providing goods or works or services related

to the same project;
d. A Bidder eventually appointed to provide services for this Project shall be
disqualified from subsequently providing goods or services related to the same
Project and any breach of this obligation shall be construed as Conflict of Interest;
provided that the restriction herein shall not apply after a period of 24 months from
the completion of this assignment; provided further that this restriction shall not apply
to services performed for the NHA in continuation of this project or to any
subsequent services performed for the NHA where the conflict of interest situation
does not arise.
e. In the event that the bidder, its Associates or affiliates are auditors or financial
advisers to any of the Bidders for the Project, they shall make a disclosure to the
NHA as soon as any potential conflict comes to their notice but in no case later than
7 (seven) days from the receipt of such proposals and any breach of this obligation
of disclosure shall be construed as Conflict of Interest. The NHA shall, upon being
notified by the bidder under this Clause, decide whether it wishes to terminate this
Consultancy or otherwise, and convey its decision to the bidder within a period not
exceeding 15 (fifteen) days.
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6. Bid Process
6.1. Pre-Bid Queries
Any clarification regarding the RFP can be submitted to NHA as per the submission mode and
timelines mentioned in the Fact Sheet. The pre-bid queries should be submitted in the format
as mentioned in Annexure I of this RFP, along with name and details of the Bidder submitting
the queries. Any requests for clarifications received after the expiry of the due date and time
mentioned in the fact Sheet shall not be entertained by NHA. Further, NHA reserves the right
to issue or not issue any responses/clarifications/ corrigendum at its own discretion.
6.2. Pre-Bid Conference

NHA will organize a pre-bid conference with the prospective bidders as per details provided in
the Fact Sheet and may respond to any request for clarifications on, and/or modifications of this
RFP. It may formally respond to the pre-bid queries after the pre-bid conference as mentioned
in the Fact Sheet. Only persons, duly authorized by the Bidder, will be allowed to participate in
the pre-bid meeting. The authorized representatives should carry a valid proof of identification
for verification before the commencement of the pre-bid Conference.
6.3. Responses to Pre-Bid Queries and Issue of Corrigendum

a. NHA will endeavor to provide timely response to all the queries. However, NHA
makes no representation or warranty as to the completeness or accuracy of any
response made in good faith, nor does it undertake to answer all the queries that
have been posed by the Bidders.
b. At any time prior to the last date for receipt of bids, NHA may, for any reason,
whether at its own initiative or in response to a clarification requested by a
prospective Bidder, modify the RFP Document. Any modifications of this RFP, which
may be necessary as a result of the pre-bid conference or for any other reason, shall
be made available by NHA exclusively through a corrigendum/addendum. Any such
corrigendum shall be deemed to be incorporated into this RFP.
The Corrigendum (if any) & clarifications to the queries from all bidders will be posted on the
website or emailed to respective bidders.
In order to provide prospective bidders reasonable time for taking the corrigendum into account,
NHA may, at its discretion, extend the last date for the receipt of RFP Proposals.
6.4. Submission of Response

a. A two staged bid system will be followed for this RFP with quality and cost based
selection (QCBS) criterion. The three envelopes are –
EMD and NDA
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Technical Bid and

Commercial Bid.
b. The bid response are to be submitted on central public procurement portal (CPPP)
i.e. https://eprocure.gov.in/eprocure/app.
c. The Bidder should take into account any Corrigendum to this RFP document that
may have been published before submitting their Proposals. The Proposal is to
submitted in three covers as mentioned below:
Cover Cover Name Content
Number
One EMD and NDA Signed Non-Disclosure Agreement (in
the format provided by NHA)
Signed Integrity Pact (annexure VII)
EMD (Annexure II, section 11.2)
Power of attorney/Board
Resolution/Letter of authorization (as
per section 5.8)
Two Technical Bid Technical Proposal as per section
7.2.2 and Annexure III along with the
required supporting documents.
Checklist of all documents submitted
Three Commercial Bid Commercial Proposal as per
Annexure IV along with the required
supporting documents.
Cover letter
Check list
Table 3: Three cover bid submission
Each bid should be submitted in a different cover/envelope on the e-Procurement Portal with
the name of the envelope (EMD and NDA/Technical/Commercial)
The Bidders are requested to go through the RFP document carefully to understand the
documents required to be submitted and the process to be followed as a part of the Proposal.
Any deviations may lead to rejection of the Proposal.
The Bidder should try to submit the proposal well before the last date and hence to avoid any
inconvenience at the last moment. The Bid submission date and time will be as mentioned in
the “Fact Sheet”. The Bidder will not be allowed to submit the Proposal after the Bid submission
time.
Each document submitted by the bidder in pre-qualification and technical and commercial
proposals must be duly signed by the authorized signatory as per section 5.8.
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6.5. Selection of Bidders

6.5.1. Opening of Proposals
The Proposals will be opened by NHA in the presence of Bidders or their representatives who
may be present at the time of opening. The representatives of the bidders are advised to carry
the identity card or a letter of authority from the bidder firms to identify their bonafide for
attending the opening of the proposal.
There will be two bid-opening events
a. Cover 1 (EMD / NDA) and Cover 2 (Technical Proposal): These shall be opened on
the same date, if Cover 1 documents are in place and hard copies are duly shared,
Cover 2 shall be opened.
b. Cover 3 (Commercial Proposal)
The venue, date and time for opening the Pre-qualification Proposal, Technical Proposal and
Commercial Proposal are mentioned in the Fact Sheet. The Technical Proposals of only those
bidders will be opened who clears the Pre-qualification stage and the Commercial proposals of
only those bidders who qualifies the technical evaluation shall be opened.
6.5.2. Preliminary Examination of Proposals
NHA will examine the Proposals to determine whether they are complete, whether the
documents have been properly signed and the proposals are generally in order. Any proposals
found to be non-responsive for any reason or not meeting any criteria specified in this RFP, will
be rejected by the NHA and shall not be included for further consideration.
Initial proposal scrutiny will be held and the proposals will be treated as non-responsive, if they
are:
a. Not submitted in the format as specified in this RFP document;
c. Received without the Letter of Authorization/Power of Attorney/Board Resolution;
d. Found with suppression of details;
e. Submitted with incomplete information;
f. Submitted without the documents required under this RFP;
g. Non-compliant to any of the clauses mentioned in this RFP;
6.5.3. Clarification on Proposals
During the RFP evaluation, NHA may, at its discretion, ask the Bidder for a clarification of its
Proposal. The request for clarification and the response shall be in writing, and no change in
the substance of the Proposal shall be sought, offered, or permitted.
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7. Evaluation Process and Criteria

7.1. Evaluation Process
7.1.1. Stage 1: Pre-Qualification
a. NHA shall open “Cover 1” marked “EMD/NDA” submitted online by the bidders in
the presence of the bidder’s representatives. The EMD/NDA proposal MUST contain
all the required documents mentioned in the RFP. Each of the EMD/NDA condition
mentioned in the RFP is MANDATORY. In case the Bidder does not meet any one
of the conditions, the bidder will be disqualified.
7.1.2. Stage 2: Technical Evaluation
Cover 2 marked as “Technical Proposal” will be opened only for bidders who succeed in Stage
1, in the presence of the bidder’s representatives.
a. NHA will review the technical proposals of the short-listed bidders to determine
whether the technical proposals are substantially responsive. Proposals that are not
substantially responsive are liable to be disqualified at NHA’s discretion.
b. The bidder’s technical proposal will be evaluated as per the requirements specified
in the RFP and technical evaluation framework as mentioned in Section 7.2.2.
c. Each Technical Proposal will be assigned a technical score out of a maximum of
100 marks. To technically qualify the RFP stage, Bidders will have to secure both of
the following-
Attain an aggregate Technical Score of 70% or more
Score at least 70% in individual sections and sub-sections (as indicated in
section 7.2.2) of Technical Evaluation
7.1.3. Stage 3: Commercial Evaluation
a. The Commercial Bids of only the technically qualified bidders will be opened by the
EC (Evaluation Committee – constituted by NHA) in the presence of the bidder’s
representatives.
d. If a firm quotes NIL charges / consideration, the bid shall be treated as unresponsive
and will not be considered.
e. Any conditional bid would be rejected.
f. Only fixed price commercial bids indicating total price for all the deliverables and
services specified in this bid document will be considered (As per annexure IV).
g. The bid price will include all taxes and levies and shall be in Indian Rupees. Only
GST shall be paid by the NHA.
h. If there is a discrepancy between words and figures, the amount in words will prevail.
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7.2. Evaluation Criteria

NHA shall evaluate the responses of the bidders to this RFP and scrutinize the supporting
documents / documentary evidence. Inability to submit the requisite supporting documents /
documentary evidence by the bidders, may lead to rejection. The decision of NHA in the
evaluation of proposals shall be final. No correspondence will be entertained outside the
process of evaluation with NHA. NHA may ask for meetings with the Bidders or may issue in
writing/email to seek clarifications or conformations on their proposals. During the Proposal
Evaluation, NHA reserves the right to reject any or all the proposals. Each of the Proposals
shall be evaluated as per the criteria and requirements specified in this RFP. NHA may
constitute an Evaluation Committee (EC) to evaluate the Proposals of the bidders. The EC
constituted by the NHA shall evaluate the responses to the RFP and all supporting documents
& documentary evidence as mentioned in this section. NHA (or a nominated party) reserves the
right to check/ validate the authenticity of the information provided in the Pre-qualification,
Technical Evaluation criteria and Commercial Evaluation and the requisite support must be
provided by the Bidder.
The evaluation criteria is as follows-
7.2.1. Pre-Qualification Criteria
Only the bidders found eligible as a result through the First Level EoI Process shall be eligible
under this bid. The names of the organizations eligible to participate in the bidding process are:
a. MFX Infotech Privat limited
b. LexisNexis Risk solution Division
c. SAS institute India Pvt. Limited
d. Optum global solutions India private limited
7.2.2. Technical Evaluation Criteria

While the Bidder will be evaluated on the criteria mentioned below and the documents specified
in Annexure III, non-submission of any document may lead to rejection of the proposal. The
Bidder's technical Proposal will be evaluated as per the evaluation criteria mentioned in the
following table:
criteria Details Marks

As finalized in the evaluation done by NHA (15
marks)
Solution Efficacy (based on
POC Outcome results)
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Overall 20 marks divided as:

Solution Originality / Overall Solution Design and Roadmap 10
Features / Future Roadmap Overall Solution and Technical Architecture 10
Solution Support / Overall 15 marks divided as:

Maintainability Adaptability of the solution to incorporate 8
feedback to reduce false positives and handle
errors
Scalability of the solution 7
Configuration v/s New As evaluated during capability showcase by the

Development Capabilities organization in submitted proposal and
presentation (25 marks)
Ease of use / Integration Overall 25 marks divided as:

capabilities Ease of integration with existing PM-JAY ecosystem
10
User interface and visualization tool ( Drill down 15
and drill through dashboards)
TOTAL 100
Table 4: Technical evaluation criteria (TEC)
The overall technical cut-off will be 60%. The bidder needs to qualify the sectional and sub-
sectional cut-off for each of the evaluation criteria specified in the table above in order to qualify
in the technical evaluation stage. If a bidder doesn’t qualify in any section and any sub sectional
criteria then it will be disqualified. The bidders who qualify the minimum technical cut-off shall
be assigned marks based on their proposals. The bidder with highest total marks shall be placed
at T1 and subsequent bidder on T2 and so on.
The following sections explain how the bidders will be evaluated on each of the evaluation
criteria. Technical presentation and product demo
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# Parameter Details Marks Minimum

Allotted cut-off
(70%)
1 Presentation Presentation to NHA on the proposed solution, 40 28
of bidder’s architecture adherence to standards approach and
approach & methodology, work plan, understanding and ability
methodology to meet timelines proposed by the Bidder to
address the scope of work as presented in the
RFP. Demo of the product which provides detailed
understanding of all aspects of the product to meet
the given solution requirements along with product
roadmap. Evaluation would be based on the
Applicant’s approach and quality of presentation.
The presentation to be made by the proposed
Project Manager. The bidders are required to
submit presentation to NHA one day before the
schedule of the presentation.
Total 40 28
Table 5: TEC (Technical presentation and product demo)
7.2.3. Commercial Evaluation Criteria

a. The bidders are required to quote the total cost of project (as anticipated by the
bidder) as per the table indicated in Annexure IV. The evaluation shall be done on
the basis of total cost submitted by the bidder (₹ ‘X’).
In case only one bidder qualifies after the technical evaluation, NHA will have right to select the
single qualified bidder or cancel the RFP.
Bidder’s needs to provide their commercial bid as per the format provided in the RFP
(Annexure-IV).
Commercial evaluation shall be conducted on the basis of the total price rate quoted by the
respective bidders and basis that bidders will be placed at L1 (i.e. at lowest cost), L2 and so
on.
In case of any discrepancy, the amount in WORDS shall be treated final.
7.2.4. Combined and final evaluation
a. The technical and financial scores secured by each bidder will be added using
weightage of 70% and 30% respectively to compute a Composite Bid Score.
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b. Key formulae for combined and final evaluation-

Parameter Formulae
Normalized technical score of a bidder = (Technical marks awarded to the bidder) ÷
(Score of the T1 bidder)
Normalized financial Score of a Bidder = (Commercial Bid of L1 bidder) ÷
(Commercial Bid of the Bidder)
Table 6: Formulae for final evaluation
i. The bidder securing the highest Composite Bid Score will be adjudicated as the
most responsive Bidder for award of the Project.
j. The overall score will be calculated as follows:-
On = 0.70 * Tn + 0.30* Fn
Where,
On = overall score of bidder
Tn = Normalized Technical score of the bidder
Fn = Normalized Financial score of the bidder
k. The bidder with highest ‘Overall score (On)’ shall be adjudicated as the best value
bidder for award of contract.
l. In the event the combined bid scores are ‘tied’, the bidder securing the highest
technical score will be adjudicated as the Best Value Bidder for award of the Project.
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8. Award of Contract
8.1. Award Criteria
NHA will award the Contract to the successful bidder (“best valued bidder” as per section 7.2.4)
whose proposal has been determined to be substantially responsive and has been determined
as the most responsive bids as per the process outlined above (in section 7 of this RFP) i.e.
bidder with Highest On score.
8.2. Letter of Award

Prior to the expiration of the bid validity period, NHA will notify the successful bidder in writing
or by fax or email through a letter of award. In case the tendering process / public procurement
process has not been completed within the stipulated period, NHA, may like to request the
bidders to extend the validity period of the bid. The letter of award will constitute the formation
of the contract. Bid securities of the unsuccessful bidders shall be returned to them at the
earliest after expiry of the final bid validity and latest on or before the 30th day after the award
of the contract to the successful bidder.
8.3. Performance Guarantee

The NHA will require the selected bidder to provide a Performance Bank
Guarantee/Performance security, within 7 days from the Notification of award, for a value
equivalent to 10% of the total cost of project. The Performance Guarantee shall be kept valid
by the bidder till completion of the project. The Performance Guarantee shall contain a claim
period of three months from the last date of validity. The selected bidder shall be responsible
for extending the validity date and claim period of the Performance Guarantee as and when it
is due on account of non-completion of the project. In case the selected bidder fails to submit
performance guarantee within the time stipulated, the NHA at its discretion may cancel the
order placed on the selected bidder without giving any notice. NHA shall invoke the
performance guarantee in case the selected Bidder fails to discharge their contractual
obligations during the period or NHA incurs any loss due to Bidder’s negligence in carrying out
the project implementation as per the agreed terms & conditions. The performance
guarantee/security may either be submitted as per format indicated in annexure V of this RFP
or through an account payee demand draft.
8.4. Contract Signing

a. Within 7 days of receipt of the notification of award or letter of award (LOA), the
successful Bidder shall communicate its acceptance to the said letter of intent and
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shall also submit the Performance Bank Guarantee (PBG) in accordance with the
terms of this RFP. Refer Annexure V.
h. Within 7 days of the notification of award, the successful bidder shall execute the
Services Agreement/contract.
If the successful bidder fails to execute the agreement or furnish the PBG within the stipulated
time period (or such other extended timelines as agreed by the NHA in its sole discretion), the
NHA shall have the right to forfeit the EMD of successful bidder and award the work to the next
successful bidder.
The successful bidder is expected to commence its service within 7 days from its acceptance
to notification of award of contract by NHA.
8.5. Failure to Agree with the Terms and Conditions of the

RFP
Failure of the successful bidder to agree with the Proposed Contract terms and Terms &
Conditions of the RFP shall constitute sufficient grounds for the annulment of the award, in
which event NHA may award the contract to the next best value bidder or call for new proposals
from the interested bidders. In such a case, the NHA shall invoke the PBG of the most
responsive bidder.
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9. Payment Terms
a. The payments shall be made to the selected agency on the basis of the amount
specified by the bidder in their commercial proposals (Annexure IV, section 13.2).
b. The payments are divided as per the following table:
i. Fixed Value: This shall be 50% of the overall cost quoted by the selected
bidder. The same shall be divided as:
Deliverables Deliverable Timeline Payment % of

Total Fixed
value
Project Project kick off 1. Kick off meeting presentation T+1 Week
Inititation Deployment of key 2. List of key personnel
personnel deployed, CVs and Attendance
register
Submission of key Deliverables: T+2 Weeks
documents i. Submission of charter
ii. Submission of detailed project
plan
Broad technical Deliverables: T+2 Weeks
architecture and BOM i. Design high level technical,
deployment, network
architecture and approval from
NHA
ii. Discussion on BOM and
approval from NHA
Environment Setup of Development System report to NHA T+3 Weeks
Setup Environment
Setup of Staging System report to NHA T+4 Weeks
Environment
Setup of Test System report to NHA T+4 Weeks
Environment
Setup of UAT System report to NHA T+4 Weeks
Environment
Setup of PROD System report to NHA T+4 Weeks
Environment
Requirement Requirements Analysis Requirement Signoff from NHA T+2 Weeks
Analysis Preparation and Requirement Signoff from NHA T+5 Weeks 10%
submission of SRS and
System Design Document
Fraud Fraud Analytics Triggers Triggers from API to SAFU T+5 Weeks
Analytics to SAFU
Triggers Analytics Solution UAT from NHA T+5 Weeks
development, unit
testing, integration
testing
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Fraud Develop/Customization T+16 Weeks 10%

Analytics and integration of Case
Control and Management, Alert
Tracking management and
System Workflow with PM-JAY
ecosystem
Audit Audit and certification of T+18 Weeks
certification FACTS Solution by CERT-
In
empaneled vendor and
3rd Party Audit Agency
(TPAA)
Sign off on signoff from NHA on Steady T+32 Weeks 20%
FACTS state of the FACTS
BAU Business as Usual (from T+156 Weeks 60%
T+ 18 to T+156 Weeks)
ii. Variable Value: The variable value shall be 50% of the total cost value quoted
by the selected bidder. This shall be dependent on the total amount of True
Positive Cases / Total Amount of case submitted (during the review period)
and further be payable as:
<<Please insert the table in the presentation>>
Payment of the variable component will be 100% “outcome based.”
Outcome: Total amount of True Positives cases/Total amount of case

submitted (during the review period**)
Outcome % of Variable component to be paid
80% and Above 100% of Variable Amount
Below 80% and Above 70% 80% of Variable Amount
Below 30% NIL
The eligible partner would be required to meet the minimum requirement

both on the number of cases submitted per month and also on the
minimum amount of the submitted cases pertain to the overall number of
“Non – Rejected pre-authorizations” for a particular month.
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Parameter1 i.e. Minimum number of Parameter 2 i.e. Minimum number of

Year
Cases non reject Pre-Auth amount
Year 1 0.50% 0.50%
Year 2 1.00% 1.00%
Year 3 1.50% 1.50%
For e.g. for Year 1:
Minimum requirement Minimum requirement

Total # cases in Total Amount of Pre- on Parameter 1 # of on Parameter 2 # of
the month Auth amount Cases Cases
300,000 2,250,000,000 1,500 11,250,000
Table 7: Payment milestones

Payments shall only be made if all deliverables and scope is met for a particular milestone (refer
section 4 of the RFP).
As part of tax payments only applicable GST shall be paid by NHA.
Payments as stipulated above shall be subject to meeting the service levels by the agency as
defined in section 9.2 of this RFP and appropriations to the amount being paid shall be done (if
applicable). Any penalties/ liquidated damages, as applicable, for delay and non-performance,
as per the criterion mentioned in this bidding document, will be deducted from the payments for
the respective milestones.
Advance payments will not be made.
In case of disputed items, the disputed amount shall be withheld and will be paid only after
settlement of the dispute.
Agency will execute the work as per Tender document with agreed schedule of rates. No extra
payment will be entertained.
The payments to the agency shall be subject to the fulfillment of the following service levels and
penalties-
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9.1. Penalties for delay in Go-Live

In case the Go-live is delayed beyond the timeline specified in the RFP then the following
penalties shall be applicable on the agency-
# Go-live delay LD’s
1. No delay i.e. go-live on or before 6 months from on- 0%
boarding of the agency
2. One week after completion of 6 months from on- 1% (of component A of the
boarding commercial bid) for each
week of delay – maximum up
to 10% value of component
A of the commercial bid.
Table 8: Penalties for delay in Go-Live
9.2. Service levels and penalties

a. The service levels will come in to effect from the date of commissioning (go-live) and
shall remain in-force until the successful completion of the operation and
maintenance support period for the project. The agency has to comply with service
levels to ensure adherence to project timeline, quality and availability of services.
b. Service levels shall be measured on quarterly basis.
c. Service levels shall be reviewed after every one year and NHA has the right to
modify the service levels to which the agency shall comply to any such modifications.
i. All applications/modules developed shall be made available on 24x7x365 basis. The
support as per working of NHA. The problems encountered during the usage of the
application would be reported at the Helpdesk. This would enable the Helpdesk staff
to log complaints and take action as per the severity of the reported problem.
j. All service levels shall be measured on quarterly basis and total time shall be
measured on a 24 x 7 basis
For the purpose of service levels requirements the following terms shall have the meaning set
forth below-
S. No. Term Definition
1. Uptime • It shall mean the time period for which the specified services /
components/modules/application with specified technical and
service standards are available to the NHA.
• Uptime, in percentage, of any component (Non-IT & IT) can be
calculated as-
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S. No. Term Definition

Uptime = {1- [(Downtime) / (Total Time – Maintenance Time)]}
* 100
2. Downtime • It shall mean the time period for which the specified services /
components/modules/application with specified technical and
service standards are not available to the NHA.
• It excludes the scheduled downtimes (on prior approvals from
NHA).
3. Incident • Refers to any events/abnormalities in the functioning of the
Application that may lead to disruption in normal operations.
4. Response • It shall mean the time interval between the time the incident is
Time reported to the Helpdesk and the time an engineer is assigned to
the call.
5. Resolution • It shall mean the time taken (after the incident has been reported
time at the Helpdesk), in resolving (diagnosing, troubleshooting and
fixing) and conveying the same to the end user.
6. Quarterly • Average of the month wise scores shall be taken for the quarterly
service measurement.
level • All service levels detailed in this section shall be measured on a
monitoring quarterly basis
Table 9: Definitions (service levels)
The following service levels are applicable on the agency from the date of Go-live of the
solution-
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# Service level Baseline level Breach Penalty Measurement

parameter
1. Application ‘up- >=99.5% <99.5% to 97% 2 % of the applicable
time’ (except during schedule quarterly payment
downtime – this needs to <97.5% to 95% 5 % of the applicable
intimated by agency and quarterly payment Agency shall ensure that all
approved by NHA) <95% and below 25 % of the applicable relevant events are logged
quarterly payment and such logs are made
2. Number of 0 hours 0-2 hours 2 % of the applicable accessible to the NHA for
hours the NHA quarterly payment review/ report in a readable
FACTS system 2-4 hours 5 % of the applicable format. End-to-end loop back
(Web quarterly payment mechanism must be
Application or 4- 8 hours and further down 25 % of the applicable established for checking the
Web Portal) is quarterly payment availability of services.
non-functional/
non- accessible/
non-available/
3. Time for <=3 seconds <3 seconds and <=5 seconds 2 % of the applicable This metric will be measured
opening of web quarterly payment as the elapsed time between
portal >5 seconds and below 25 % of the applicable the action link/button being
quarterly payment clicked and its response
appearing on portal on real
time live environment.
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parameter
4. Average 15 minutes from call logged More than 15 minutes ₹ 1000 per incident per Automated report from ticketing
response time hour delay system/tool.
5. Average 2 hours More than 2 hours ₹ 1000 per incident per
resolution time hour delay
6. Non availability 0 days/hours Breach of baseline ₹ 4000 /- per day of All deviations to be recorded
of deployed (Exception- 18 leaves allowed in absence. and MIS report to be made
manpower a year per resource – 4.5 pro (Maximum – 10% of available to NHA.
onsite rata for a quarter – after approval the applicable quarterly
from NHA) payment)
7. Completion of No delay Breach of baseline 2 % of the quarterly All deviations to be recorded
Performance payment and MIS report to be made
testing and available to NHA.
closure report
(To be
conducted once
every year)
8. Capacity Agency to provide a minimum If training provided is <40 2 % of the Total Feedback rating- If 10% of the
building of 40 hours of training to each hours or no specialized contract value end user reports that training
of the end user i.e. NHA training provided on new provided to them is non-
officials during a calendar year enhancements/developments. satisfactory
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parameter
In case of any enhancements or
new developments the agency
shall provision for a specialized
training on such new
developments which shall be
beyond the scope of the
mandated 40 hours training.
Table 10: Service levels
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10. Annexure I: Template for Pre-Bid

Queries
Bidder shall submit all pre-bid queries in excel in the following format.
Sheet 1: Bidder’s Information
Information Sought Details provided by the bidder
Name (Authorized
Signatory)
Designation
Company
Address
Contact Number
e-Mail ID
Date
Table 11: Pre bid queries (bidders information)

Note: Please paste the table above in email body as well
Sheet2: Clarification Requested/Format for pre-bid query submission
# Page Section No. Section Statement as per RFP Query by
No Name document bidder
Table 12: Format for pre bid queries

Page Number – Page Number of this RFP as reflected at the bottom right
corner. The bidders to mention only the page number. Ex. ‘29’ as page number
and not ‘29 of 156’.
Section No. – Example – ‘8’ and not ‘Section 8’
Section Name – Example – Scope of Work (Should be exactly the same as
provided in the RFP)
Notes –
a. The queries are to be submitted in the format provided above only and as per
schedule (refer-fact sheet) only. The bidders to ensure that they enter correct details
in the format. In case of any inappropriate details being mentioned the NHA shall
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not be responsible for the same and such queries may be discarded from providing
any response.
k. The bidders to ensure that no cell merging (in excel) is done by them while preparing
the query.
The bidders to ensure that each of the query submitted by them is unique and no duplicate
query is submitted by them as a result of copy-paste. It is expected from the bidder to carry out
its own due-diligence before submitting the queries.
Bidders are expected to do a thorough check of the queries and ensure the completeness of
the queries and spelling checks etc. before submitting the same to NHA.
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11. Annexure II: Pre-Qualification
11.1. Response to pre-qualification criteria

Bidders are required to submit their letter of eligibility for RFP issued by NHA.
11.2. Format for Bank Guarantee Earnest Money Deposit

Bidders are required to submit bid security/EMD as mentioned in section 5.4 of this RFP in the
below format-
(To be stamped in accordance with Stamp Act)
The non-judicial stamp paper should be in the name of issuing Bank
Ref………………. Bank Guarantee No…………………......
Date………………………………………...
To
9th Floor, Tower-I
Jeevan Bharti Building
Connaught Place
New Delhi – 110001
Dear Sir/s,
a. In accordance with Invitation to Bid under your Specification No……………. M/s

……. having its Registered/Head Office at…………………… (hereinafter called the
‘Bidder’) wish to participate in the said Bid or………………. and you, as a special
favor have agreed to accept an irrevocable and unconditional Bank Guarantee for
an amount of…………… valid up to ………… on behalf of Bidder in lieu of the Bid
deposit required to be made by the Bidder, as a condition precedent for participation
in the said Bid.
l. We, the …………………. Bank at ……………… (local address) having our Head
office at ………………………. guarantee and undertake to pay immediately on
demand by National Health Authority (NHA), the amount of ……………………… (in
words & figures) without any reservation, protest, demur and recourse. Any such
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demand made by said ‘Owner’ shall be conclusive and binding on us irrespective of

any dispute or difference raised by the Bidder.
This guarantee will not be discharged due to the change in the constitution of the Bank or the
Bidder.
Notwithstanding anything contained hereinabove:
Our liability under this guarantee is restricted to ₹. ……………. (in words &
figures).
This Bank Guarantee will be valid up to ………………….; and
We are liable to pay the guarantee amount or any part thereof under this Bank
Guarantee only upon service of a written claim or demand by you on or before
………….
In witness whereof the Bank, through its authorized officer, has set its hand and stamp on
this……………. day of………….2018……….at…………
WITNESS
…..………………….……… …………..………………….………
(Signature) (Signature)
……..………………….……… ……………..………………….………
(Name) (Name)
……..………………….……… ……………..………………….………
(Official Address) (Designation with Bank Stamp)
Attorney as per Power of Attorney No…………….

Dated………………
11.3. Format- Undertaking (no conflict of interest)

The certificate below is to be provided by the bidder.
Certificate for undertaking for No Conflict of Interest
We hereby confirm that our company <insert name of the company> is not involved in any
conflict of interest situation with one or more parties in this bidding process, including but not
limited to –
a. Receive or have received any direct or indirect subsidy from any of them; or
m. Have common controlling shareholders; or
Have the same legal representative for purposes of this Bid; or
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Have a relationship with each other, directly or through common third parties, that puts them in
a position to have access to information about or influence on the Bid of another Bidder, or
Influence the decisions of NHA regarding this bidding process; or
Participation in more than one bid in this bidding process. Participation in more than one Bid
will result in the disqualification of all Bids. However, this does not limit the inclusion of the same
product (commercially available hardware, software or network product manufactured or
produced by the firm), as well as purely incidental services such as installation, configuration,
routine training and ongoing maintenance/support, in more than one bid; or
Participation as a consultant in the preparation of the design or technical specifications of the
goods and services that are the subject of the bid.
Association as Consultant/ Advisor/ Third party independent evaluating agency with any of the
agencies taking part in the bid process.
(Signature of the Authorized signatory of the Bidder)

(Name, Designation, Seal, Date, Place, Business Address)
11.4. Format – self declaration for non-black listing

The certificate below is to be provided by the bidder.
<To be printed on Company letterhead>
We confirm that our company _____________________ as on date of submission of the
proposal is not blacklisted by any Central/State Government/PSU entity in India for corrupt,
fraudulent or any other unethical business practices.
Sincerely,
(Signature)
(Name and signature of Company Secretary)
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12. Annexure III: Technical Proposal

Format
Bidders are required to submit their compliances to the technical evaluation criteria, along with
documents required, as stated in section 7.2.2 of this RFP along with the following details-
12.1. Profile of the bidding firm

Bidders are required to submit their details in the following format-
S. No. Item Bidder’s Response
1. Company Name
2. Year Established
3. Incorporated in India (Yes or No)
4. PAN
5. GST
6. CIN
7. Contact Name and position
8. Head Office Address
9. Mobile
10. Telephone
11. Fax Number
12. Email Address
13. Brief Description of the Organization
14. Office Address (from where services will

be delivered)
15. Key representative for this project
16. Name and contact details of the CEO
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Table 13: Bidders profile
12.2. Resource deployment plan

The bidder is required to submit separate resource deployment plans for both phase 1 and
phase 2”.
Team Name Team Lead Total number of Total Man Months
resources Effort
Phase 1: Resource deployment
<Functional>
< Development>
…..
Operations team
Maintenance team
Enhancement team
Data Science team
Analytics team
…..
Total ____ _____
Table 14: Resource deployment plan

*the team names inserted in the above table are for illustration only and the bidder may modify
and propose its own team structures for deployment in the technical bid.
12.3. Format- CV’s of proposed resources

The bidder must provide CVs of all the key resources mentioned in Section 7.2.2.4 of the RFP
in the following format-
S. Item Bidder’s Response
No.
1. Name of the Resource
2. Specify role to be played in the

project
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S. Item Bidder’s Response

No.
3. Name of Employer
4. Number of years with the Current

Employer
5. Total Experience (in Years)
Experience in yrs. (Provide details regarding name of organizations worked for, Designation,
responsibilities, tenure etc.atleast for last 5 years)
S. Name of From To Designation/
No. Employer Responsibilities
1.1. 1
1.2. 2
Summarized professional experience (Relevant to the Current Project) in reverse chronological

order
S. From To Company Project Position Relevant
No. Functional, Technical and Managerial
experience
1.3. 1
1.4. 2
Educational Background, Training Certification including institutions, % of marks, specialization

areas etc.
S. Degree Year of Award University % of marks
No. of Degree
1.5. 1
1.6. 2
Table 15: CV Format
12.4. No Deviation certificate

A certificate in the below format to be provided by the bidder-
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This is to certify that our offer is exactly in consonance with your RFP no. _________ dated
__________ issued by National Health Authority and subsequent amendments/corrigendum’s
etc. This is to expressly certify that our offer contains no deviation on the solution requirements
and scope of work, Legal or Commercial aspects as specified in the RFP in either direct or
indirect form.
(Signature of Authorized Signatory)

12.5. Total Responsibility

A certificate in the below format to be provided by the bidder-
This is to certify that we [insert name of Bidder company] undertake the total responsibility for
the defect free operation of the proposed solution as per the requirement of the RFP <Insert
RFP # Dated____) issued by National Health Authority for the duration mentioned in RFP.
(Signature of Authorized Signatory)

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13. Annexure IV: Commercial

Proposal Format
13.1. Proposal Cover Letter
(To be submitted on the Letter head of the Bidder)
(Location, Date)
To,
9th Floor, Tower-I
Connaught Place
Ref: Submission of Commercial proposal for Request for Proposal (RFP) Notification
No._________ dated__________
Dear Sir,
a. Having examined the RFP document, we, the undersigned, herewith submit our
response to your RFP Notified vide No. ____________________ dated
__________ for NHA, in full conformity with the said RFP document.
n. We, the undersigned, offer to provide services to NHA in accordance with your RFP.
We have read the provisions of the RFP document, confirm our acceptance for the same and
we are hereby submitting our commercial Bid.
We agree to abide by this RFP, consisting of this letter, commercial bid and all requisite
supporting documents, for a period of 3 years from the closing date fixed for submission of bid
as stipulated in the RFP document.
We would like to declare that we are not under a declaration of ineligibility for corrupt or
fraudulent practices anywhere in India.
We hereby declare that we have not been charged with any fraudulent activities by any
Central/State/UT Government, PSU or autonomous body under Government of India or any
State Government.
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We have not been blacklisted or debarred by any Central/State/UT Government, PSU or

autonomous body under Government of India or any State Government for failure to execute
services as agreed upon/contracted for.
We hereby certify that we have taken steps to ensure that no person acting for us or on our
behalf will engage in bribery.
We undertake that, in competing for (and, if the award is made to us, in executing) the above
contract, we will strictly observe the laws against fraud and corruption in force in India namely
“Prevention of Corruption Act, 1988” and its amendments.
We understand that NHA is not bound to accept any bid received in response to this RFP.
In case we are engaged by NHA for executing the services, we shall provide any
assistance/cooperation required by NHA/auditing agencies appointed by it/NHA officials for
performing auditing and inspection functions. We understand that our non-cooperation for the
same shall be grounds for termination of service.
In case we are engaged as an agency, we agree to abide by all the terms & conditions of the
Contract that will be issued by NHA.
The commercial bid includes the cost of setting up and operating the services, cost of providing
additional services and performing all functions as per the ‘Scope of Work’ and ‘Service levels’
defined in this RFP.
We already have the technical and financial capability in India for carrying out the services as
detailed in the ‘Scope of Work’.
We also understand that in case of deficiencies in our services as per the requirement of RFP,
NHA reserves the right to allocate our volume of work, in full or in part, to other agency/service
provider for a limited period or on permanent basis.
Yours sincerely,
Signature of Authorized Signatory [In full as well as initials]: _______________
Name and Title of Signatory: ________________________________________
Name of Firm: ______________________________________________________
Address: ___________________________________________________________
13.2. Commercial bid format

Bidders are required to provide an all-inclusive total cost of contract as envisaged by them as
per the table indicated below-
a. The rates quoted must be inclusive of the following:
Cost for all the activities as mentioned in the RFP document and
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No extra item will be considered for payment.

Cost of material, manpower, transportation, equipment’s, tools etc.
Any other cost direct or hidden, not mentioned above.
All taxes and levies etc. applicable during currency of contract excluding GST.
GST shall be paid by NHA.
Rates entered into commercial rate page and duly signed by the authorized representative of
the bidder shall only be considered. Rates and any other financial entity in any other form / letter
head if attached by bidder shall be straightway ignored and shall not be considered.
Component Activity/ Item description All-inclusive cost (in ₹) –
Phase including all costs and taxes
(excluding GST)
A. Project Implementation Design, development, ₹ _______
Cost and implementation of all (in NUMBERS)
Management components/modules ₹ _______
and its O&M for the (in WORDS)
project period including
deployment of
resources and
deliveries as per
envisaged quality
Table 16: Commercial bid format
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14. Annexure V: Format for

Performance Bank Guarantee
(To be stamped in accordance with Stamp Act)
The non-judicial stamp paper should be in the name of issuing Bank
Ref………………. Bank Guarantee No…………………......
Date……………………………………….
To
9th Floor, Tower-I
Connaught Place
Dear Sir,
a. In consideration of the National Health Authority, Government of India, on behalf of
the CEO, NHA on behalf of the Authority, (hereinafter referred to as the ‘NHA’ which
expression shall unless repugnant to the context or meaning thereof include its
successors, administrators and assigns) having awarded to
M/s……………………………. with its Registered/Head office at ………………………
(hereinafter referred to as the “Agency” which expression shall unless repugnant to
the context or meaning thereof, include its successors, administrators, executors
and assigns), a Contract by issue of Notification of award No……………. dated
………. and the same having been acknowledged by the Agency, resulting in a
Contract, bearing No…………. dated…………valued at………for………… (scope of
Contract) and the Agency having agreed to provide a Contract Performance
Guarantee for the faithful performance of the entire Contract not exceeding ₹.
……………….. (in words & figures).
o. We……………………………… (Name & Address of Bank Branch) having its Head
office at ………………………………. (hereinafter referred to as the ‘Bank’, which
expression shall, unless repugnant to the context or meaning thereof, include its
successors, administrators, executors and assigns) do hereby guarantee and
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undertake to pay the amounts due and payable under this guarantee without any
demur, reservation, context, recourse or protest and/or without any reference to the
Agency merely on a demand from the NHA stating that the amount claimed is due
by way of loss or damage caused to or would be caused to or suffered by the NHA
by reason of breach by the said Agency(s) of any of the terms or conditions
contained in the said Agreement or by reason of the Agency(s)’ failure to perform
the said Agreement. Any such demand made on the Bank shall be conclusive and
binding not withstanding any difference between the NHA and the Agency or any
dispute pending before
Any Court, Tribunal, Arbitrator or any other authority. We agree that the guarantee herein
contained shall be irrevocable and shall continue to be enforceable till the NHA discharges this
guarantee.
The NHA shall have the fullest liberty without affecting in any way the liability of the Bank under
this guarantee, from time to time to extent the time for performance of the Contract by the
Agency. The NHA shall have the fullest liberty, without affecting this guarantee, to postpone
from time to time the exercise of any powers vested in them or of any right which they might
have against the Agency, and to exercise the same at any time in any manner, and either to
enforce or to forbear to enforce any covenants, contained or implied, in the Contract between
the NHA and the Agency or any other course or remedy or security available to the NHA. The
Bank shall not be released of its obligations under these presents by any exercise by the NHA
of its liberty with reference to the matters aforesaid or any of them or by reason of any other act
of omission or commission on the part of the NHA or any other indulgences shown by the NHA
or by any other matter or thing whatsoever which under law would, but for this provision have
the effect of relieving the Bank.
The Bank also agrees that the NHA at its option shall be entitled to enforce this Guarantee
against the Bank as a principal debtor, in the first instance without proceeding against the
Agency and not withstanding any security or other guarantee the NHA may have in relation to
the Agency’s liabilities.
This guarantee will not be discharged due to the change in the constitution of the Bank or the
Agency.
Notwithstanding anything contained hereinabove:
Our liability under this guarantee is restricted to ₹. ……………. (in words &
figures).
This Bank Guarantee will be valid up to ………………….; and
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We are liable to pay the guarantee amount or any part thereof under this Bank
Guarantee only upon service of a written claim or demand by you on or before
…………..
In witness whereof the Bank, through its authorized officer, has set its hand and stamp on
this……………. day of………….2018 at…………
WITNESS
…..………………….……… …………..………………….………
(Signature) (Signature)
……..………………….……… ……………..………………….………
(Name) (Name)
……..………………….……… ……………..………………….………
(Official Address) (Designation with Bank Stamp)
Attorney as per Power of Attorney No……………. Dated………………………………
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15. Annexure VI: Security

Requirements
a. Agency shall comply with NHA’s IS & data privacy policies in force from time to time
as applicable. NHA shall share the relevant guidelines and standards with the
Agency once institutionalized.
b. Agency shall ensure that the Application have capability to ensure compliance
against NHA IS Policy such as encryption (Data at rest, Data at transit & Data at
use), anonymization, DLP (data leak prevention) etc.
c. Agency shall upon reasonable request by NHA or his/her nominee(s) participate in
regular meetings when information technology security & Data Privacy matters are
reviewed.
d. Agency shall promptly report in writing to NHA any act or omission which they are
aware that could have an adverse effect on the proper conduct of information
technology security at NHA
e. Agency shall use reasonable endeavors to report forthwith in writing to all the
partners / contractors about the civil and criminal liabilities accruing due to any
unauthorized access (including unauthorized persons who are employees of any
Party) or interference with NHA’s data, facilities or Confidential Information
f. Agency shall ensure that they have informed NHA prior 24 hours of any resource
having access to NHA environment is relieving the project or Agency’s organization
g. Agency shall comply with all MeitY guidelines related to information security & data
privacy.
h. Right to Audit : NHA or its nominated agency shall have the right to audit and inspect
suppliers, agents and third party facilities (if any), data centers, documents, records,
procedures and systems relating to the provision under this RFP, but only to the
extent related to the scope of work stated in the RFP, as shall be reasonably
necessary to verify-
• The security, integrity and availability of all data processed, held or conveyed by
the Partner on behalf of NHA and documentation related thereto;
• That the actual level of performance of the services is the same as specified in
the service levels defined in section 9 of the RFP;
• That the Agency has complied with the relevant technical standards, and has
adequate internal controls in place; and
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• The compliance of the Agency with any other obligation under the contract.
• Security audit and implementation audit of the system shall be done once each
year, the cost of which shall be borne by the Bidder.
• For the avoidance of doubt the audit rights under this schedule shall not include
access to the Agency's profit margins or overheads, any confidential information
relating to the Bidder’ employees, or minutes of its internal Board or Board
committee meetings including internal audit, or such other information of
commercial-in-confidence nature which are not relevant to the Services
associated with any obligation under the contract
Data Security & Privacy Requirements
Agency shall be responsible to protect the privacy, confidentiality, and security of the NHAs
data. Agency must comply with international standards for data protection including ISO 27001,
and applicable regulations including IT Act and Amendments, Aadhaar Act (as applicable) and
Regulations, and proposed data privacy act and regulations including Data Protection Act and
other applicable laws and regulations, which the NHA may want the Agency to comply with.
Agency shall ensure that these security and privacy requirements are been adequately
implemented across the setup. The effectiveness shall be evaluated on a regular basis to
ensure the continuity of security and privacy requirements.
The Agency shall ensure the security and privacy requirements including, but not limited to, the
following:
• Ensure the compliance to security requirements as detailed above and also to
requirements and guidelines published by NHA from time to time. Agency shall
also ensure the compliance to upcoming security and privacy requirements as
and when these become applicable.
• Setup an assurance process to periodically review the compliance to security
and privacy requirements.
• Ensure that during the development of the product has been performed using
securing coding practices and through development methodlogy
• Agency shall be responsible for maintenance of all software managed with latest
updates, specifically related to security vulnerabilities.
• Host the systems and devices processing the data within the data centers
located in India.
• Ensure policies & procedures for secure disposition of electronic data on which
the data resides (e.g., wiping hard drive, or other method of destruction)
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• Ensure maintenance of system and application audit logs in line with applicable
regulations including IT Act and Amendments, Aadhaar Act (as applicable), and
any other Regulations made applicable from time to time.
• Ensure in case of any incident / breach notification timely (Not more than 24 hrs
of identification) intimate appropriate stakeholders of NHA and respond to
incidents / breach as per the Regulatory requirements, and international best
practices.
• NHA shall have authority to conduct (or through external agency) periodical
assessment of the security requirements to ensure compliance with security
policies, procedures, and Regulations.
• Agency shall have an appropriate contingency plan (including backup) to recover
the application services / data as and when required (including during any
disaster)
The service provider shall keep the confidentiality, maintain secrecy of all confidential
information and shall not, at any time, divulge such or any part thereof to any third party except
as may be compelled by any court or agency of competent jurisdiction, or as otherwise required
by law, and shall also ensure that same is not disclosed to any person voluntarily, accidentally
or by mistake.
Compliance with Aadhaar Act (as applicable) and Regulations: The
Service Provider and all their associates shall comply with the relevant
provisions of the Aadhaar Act 2016 and the Aadhaar Regulations 2016, while
receiving, transmitting, storing, processing or handling Aadhaar Data, including
Aadhaar Number, Demographic and Bio-metric data. Without prejudice to the
specific provisions of the Act and the Regulations, the following provisions are
brought to the notice of the bidders.
i. Any individual, entity or agency, which is in possession of Aadhaar number(s)
of Aadhaar number holders, shall ensure security and confidentiality of the
Aadhaar numbers and of any record or database containing the Aadhaar
numbers.
ii. Any individual, entity or agency, which is in possession of Aadhaar number(s)
of Aadhaar number holders shall not make public any database or record
containing the Aadhaar numbers of individuals, unless the Aadhaar numbers
have been redacted or blacked out through appropriate means, both in print
and electronic form.
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iii. Such individual, agency or entity shall not share the Aadhaar number with any
person or entity.
iv. No entity, including a requesting entity, shall require an individual to transmit
his Aadhaar number over the Internet unless such transmission is secure and
the Aadhaar number is transmitted in encrypted form except where
transmission is required for correction of errors or redressal of grievances. No
entity, including a requesting entity, shall retain Aadhaar numbers or any
document or database containing Aadhaar numbers for longer than is
necessary for the purpose specified to the Aadhaar number holder at the time
of obtaining consent.
Strategic Control of Operations to be provisioned
The final strategic control and governance shall still be with NHA for all its IT and Fraud Control
landscape management and operations.
For ensuring strategic control of the operations –
• Approval of NHA shall be taken prior making changes / modifications of the
deployed solution, database, data, configurations, security solutions etc. of the
Government Community Cloud where such changes may affect the solutions of
NHA.
• NHA shall own the super admin access of the application
• For any changes (including auto-provisioning and others that may or may not
need prior approval) to the underlying cloud infrastructure, software, etc. under
the scope of the agency, that has the potential to affect the SLAs (performance,
availability, etc.), NHA shall get alerts / notifications from the Agency, both as
advance alerts and post implementation alerts.
• NHA at its discretion may involve further users to facilitate the strategic control.
Page 89 of 94
16. Annexure VII: Integrity Pact

INTEGRITY PACT
(To be executed on ₹ 100 stamp paper)
This Agreement (hereinafter called the Integrity Pact) is made on _____ day of the month of
_____ 20___, between, on one hand, the President of India acting through Chief Executive
Officer, National Health Authority, Government of India (hereinafter called the “The Principal”),
which expression shall mean and include, unless the context otherwise requires, his successors
in office and assigns) of the First Part
And
M/s _____________represented by ___________________, Chief Executive Officer/
Authorized Signatory (hereinafter called the “Bidder/Contractor”, which expression shall mean
and include, unless the context otherwise requires, his successors and permitted assigns) of
the Second Part.
Preamble
The principal intends to award, under laid down organizational procedures, contract to design,
develop, implement, operate and maintain Fraud Analytics Control and Tracking System
for National Health Authority. The Principal values full compliance with all relevant laws of
the land, rules, regulations, economic use of resources and of fairness/ transparency in its
relations with its bidder(s) and contractor(s).
In order to achieve this the Principal will appoint Independent External Monitors (IEMs) who
will monitor the tender process and the execution of the contract for compliance with the
principal mentioned above.
Section 1 – Commitments of the Principal.
a. The Principal commits itself to take all measures necessary to prevent corruption
and to observe the following principles :-
No employee of the Principal, personally or through family members, will in
connection with the tender for, or the execution of a contract, demand, take
a promise for or accept, for self or third person, any material or immaterial
benefit which the personal is not legally entitled.
The Principal will during the tender process treat all
Bidder(s) with equity and reason. The Principal will in particular, before and
during the tender process, provide to all Bidder(s) the same information and will
not provide to any Bidder(s) confidential/additional information through which
Page 90 of 94
the Bidder(s) could obtain an advantage in relation to the process or the

contract execution.
The Principal will exclude from the process all known prejudiced persons.
If the Principal obtains information on the conduct of any of its employees which is a criminal
offence under the IPC/PC Act, or if there be a substantive suspicion in this regard, the Principal
will inform the Chief Vigilance Officer and in addition can initiate disciplinary actions.
Section 2 – Commitments of the Bidder(s)/Contractor(s)
a. The Bidder(s)/Contractor(s) commit himself to take all measures necessary to
prevent corruption. The Bidder(s)/Contractor(s) commits themselves to observe the
following principles during his participation in the tender process and during the
contract execution.
The Bidder(s)/contractor(s) will not, directly or through any other persons or
firm, offer promise or give to any of the Principal’s employees involved in
the tender process or the execution of the contract or to any third person any
material or other benefit which he/she is not legally entitled to, in order to obtain
in exchange any advantage or during the execution of the contract.
The Bidder(s)/Contractor(s) will not enter with other Bidders into any
undisclosed agreement or understanding, whether formal or informal. This
applies in particular to prices, specifications, certifications, subsidiary
contracts, submission or non-submission of bids or any other actions to restrict
competitiveness or to introduce cartelization in the bidding process.
The Bidder(s)/Contractor(s) will not commit any offence under the relevant
IPC/PC Act; further the Bidder(s)/Contractors will not use improperly, for
purposes of competition or personal gain, or pass on to others, any
information or documents provided by the Principal as part of the business
relationship, regarding plans, technical proposals and business details,
including information contained or transmitted electronically.
The Bidder(s)/Contractor(s) of foreign origin shall disclose the name and address
of the Agents/representatives in India, if any. Similarly, the bidder(s)/contractor(s)
of Indian Nationality shall furnish the name and address of the foreign
principals, if any. All the payments made to the India agent/representative have
to be in Indian Rupees only.
The Bidder(s)/Contractor(s) will, when presenting their bid, disclose any and
all payments made, is committed to or intends to make to agents, brokers or
any other intermediaries in connection with the award of the contract.
Page 91 of 94
Bidder(s)/Contractor(s) who have signed the Integrity pact shall not approach
the courts while representing the matter to IEMs and shall wait for their decision
in the matter.
The Bidder(s)/Contractor(s) will not instigate third persons to commit offences outlined above
or be an accessory to such offences.
Section 3: Disqualification from tender process and exclusion from future contract
If the Bidder(s)/Contractor(s), before award or during execution has committed a transgression
through a violation of Section 2 above or in any other form such as to put his reliability or
credibility in question, the Principal is entitled to disqualify the Bidder(s)/Contractor(s) from the
tender process or to terminate the contract, if already signed, for such reasons.
Section 4: Compensation for Damages
a. If the Principal has disqualified the Bidder(s) from the tender process prior to the
award according to Section 3, the Principal is entitled to demand and recover the
damages equivalent to Earnest Money Deposit/Bid Security.
p. If the Principal has terminated the contract according to Section3, or if the Principal is
entitled to terminate the contract according to Section3, The Principal shall be entitled
to demand and recover from the Contractor liquidated damages of the Contract
value or the amount equivalent to Performance Bank Guarantee.
Section 5: Previous Transgression
a. The Bidder declares that no previous transgressions occurred in the last three
years with any other company in any country conforming to the anti-corruption
approach or with any other government (Central/State/PSU’s) in India that could justify
his exclusion from the tender process.
q. If the bidder makes incorrect statement on this subject, he can be disqualified from
the tender process and appropriate action can be taken including termination of the
contract, if already awarded, for such reasons.
Section 6: Equal treatment of all Bidders/Contractors/Subcontractors.
a. In case of sub-contracting, the principal contractor shall take the responsibility of the
adoption of Integrity pact by the sub-contractors.
r. The Principal will enter into agreements with the identical conditions as this one with
all bidders, contractors and sub-contractors.
The Principal will disqualify from the tender process all bidders who do not sign this Pact or
violate its provisions.
Section 7: Criminal charges against violating Bidder(s) / Contractor(s) / Sub-
contractors(s).
Page 92 of 94
If the Principal obtains knowledge of conduct of a Bidder(s)/ Contractor(s) or sub-

contractor, or of an employee or a representative or an associate of a bidder, contractor or sub-
contractor which constitutes corruption, or if the Principal has substantive suspicion in this
regard, the Principal will inform the same to the Chief Vigilance Officer.
Section 8: Independent External Monitor/Monitors
a. The Principal appoints competent and credible Independent External Monitor for this
Pact after approval by Central Vigilance Commission. The task of the Monitor is to
review independently and objectively, whether and to what extent the parties comply
with the obligations under this agreement.
s. The Monitor is not subject to instructions by the representatives of the parties and
performs his/her functions neutrally and independently. The Monitor would have
access to all contract documents, whenever required. It will be obligatory for him/her
to treat the information and documents of bidders /contractors as confidential. He
reports to the CEO, NHA.
The Bidder(s)/Contractor(s) accepts that the Monitor has the right to access without restriction
to all project documentation of the Principal including that provided by the Contractor. The
Contractor will also grant the Monitor, upon his/her request and demonstration of a valid
interest, unrestricted and unconditional access to his project documentation. The same is
applicable to Subcontractors.
The Monitor is under contractual obligation to treat the information and documents
of the Bidder(s) / Contractor(s) / Subcontractor(s) with confidentiality. The Monitor
has also signed declarations on ‘Non-disclosure of Confidential Information’ and of ‘Absence of
Conflict of Interest’. In case of any conflict of interest arising at a later date, the IEM shall inform
CEO, NHA and recuse himself/herself from that case.
The Principal will provide to the Monitor sufficient information about all meetings among the
parties related to the Project provided such meetings could have an impact on the contractual
relations between the Principal and the Contractor. The parties offer to the Monitor the option
to participate in such meetings.
As soon as the Monitor notices, or believes to notice, a violation of this agreement, he will so
inform the Management of the Principal and request the Management to discontinue or take
corrective action, or to take other relevant action. The monitor can in this regard submit non-
binding recommendations. Beyond this, the Monitor has no right to demand from the parties
that they act in a specific manner, refrain from action or tolerate action.
The Monitor will submit a written report to the CEO, NHA within 8 to 10 weeks from the date of
reference or intimation to him by the Principal and, should be occasion arise, submit proposals
for correcting problematic situations.
Page 93 of 94
If the Monitor has reported to the CEO, NHA, a substantiated suspicion of an offence under
relevant IPC/PC Act, and the CEO, NHA has not, within the reasonable time taken visible action
to proceed against such offence or reported it to the Chief Vigilance Officer, the Monitor may
also transmit this information directly to the Central Vigilance Commissioner.
The word “Monitor” word include both singular and plural.
Section 9: Pact Duration
This pact begins when both parties have legally signed it. It expires for the Contractor 12
months after the last payment under the contract, and for all other Bidder 6 months after
the contract has been awarded. Any violation of the same would entail disqualification of the
bidders and exclusion from future business dealings.
If any claim is made/lodged during this time, the same shall be binding and continue to
be valid despite the lapse of this pact as specified above, unless it is discharged/determined
by CEO, NHA.
Section 10: Other Provisions
a. This agreement is subject to Indian Law. Place of performance and jurisdiction is the
Registered Office of the Principal i.e. New Delhi.
t. Changes and supplements as well as termination notices need to be made in writing.
Side agreements have not been made.
If the contractor is a partnership or a consortium, this agreement must be signed by all partners
or consortium members.
Should one or several provisions of this agreement turn out to be invalid, the remainder of this
agreement remains valid. In this case, the parties will strive to come to an agreement to their
original intentions.
Issues like Warranty / Guarantee etc. shall be outside the purview of IEMs.
In the event of any contradiction between the Integrity pact and its annexure, the clause of the
Integrity pact will prevail.
__________________________ __________________________
(For & on behalf of the Principal) (For & on behalf of Bidder/Contractor)
(Office Seal) (Office Seal)
Place _____________
Date ______________
Witness 1:
(Name & Address)
Witness 2:
(Name & Address)
Page 94 of 94

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RFP: Fraud Control Analytics Platform and Services

National Health Authority (NHA)

REQUEST FOR PROPOSAL (RFP)

“Selection of an agency to design, develop, implement,

RFP Number: S-12013/2018-19/49/Finance

2. FACT SHEET AND RFP SCHEDULE ................................................................................................. 9

3.1. BACKGROUND ................................................................................................................................ 11

4. SCOPE OF WORK ............................................................................................................................. 16

4.1. PROJECT BACKGROUND ............................................................................................................... 16

5. INSTRUCTIONS TO BIDDERS .......................................................................................................... 43

5.1. OBJECTIVES OF THIS RFP............................................................................................................... 43

5.19. RIGHT TO TERMINATE THE PROCESS ............................................................................................. 50

6. BID PROCESS ................................................................................................................................... 53

6.1. PRE-BID QUERIES .......................................................................................................................... 53

7. EVALUATION PROCESS AND CRITERIA ....................................................................................... 56

7.1. EVALUATION PROCESS ................................................................................................................... 56

8. AWARD OF CONTRACT ................................................................................................................... 61

8.1. AWARD CRITERIA ........................................................................................................................... 61

9. PAYMENT TERMS ............................................................................................................................. 63

9.1. PENALTIES FOR DELAY IN GO-LIVE .................................................................................................. 66

10. ANNEXURE I: TEMPLATE FOR PRE-BID QUERIES .................................................................... 71

11. ANNEXURE II: PRE-QUALIFICATION ............................................................................................ 73

11.1. RESPONSE TO PRE-QUALIFICATION CRITERIA ................................................................................. 73

12. ANNEXURE III: TECHNICAL PROPOSAL FORMAT ..................................................................... 76

12.1. PROFILE OF THE BIDDING FIRM ...................................................................................................... 76

13. ANNEXURE IV: COMMERCIAL PROPOSAL FORMAT ................................................................ 80

13.1. PROPOSAL COVER LETTER......................................................................................................... 80

14. ANNEXURE V: FORMAT FOR PERFORMANCE BANK GUARANTEE ....................................... 83

15. ANNEXURE VI: SECURITY REQUIREMENTS ............................................................................... 86

16. ANNEXURE VII: INTEGRITY PACT ................................................................................................ 90

b. LexisNexis Risk Solution Division

c. SAS Institute India Private Limited

d. Optum Global Solutions India Private Limited

2. Fact Sheet and RFP Schedule

S. No. Reference Description

3.2. AB-PMJAY – Key Features

3.3. Role of Government of India/NHA

3.4. Role of State Government/SHA

4.1. Project Background

4.1.1. What Constitutes Fraud

4.1.2. Types of Fraud and who may conduct it

Payer Fraud conducted by a staff or consultant of NHA or SHA or

Beneficiary fraud means fraud conducted by an eligible beneficiary of AB-PMJAY and

• Giving gratifications to service providers to provide excluded/uncovered

• Repeated billing (claim repeated for the same case);

4.1.3. Shortlisting of Organizations and conducted PoC

I. MFX Infotech Private limited

II. LexisNexis Risk Solution Division

III. SAS Institute India Private Limited

IV. Optum Global Solutions India Private Limited

4.1.4. Broad Scope of Work

should be released from CPD/PPD bucket and simultaneously if a case is marked

4.1.6. Solution Overview

4.2. Business Requirements

c. Allow creation of specific interest groups for closed group interaction.

b. Other documents basis case requirements, including supporting documents,

f. The solution should be capable of machine learning to assist in fine-tuning the

4.3. Timelines and Term of contract

Setup of UAT System report to NHA T+4 Weeks

4.4. Solution Requirements

Architecture is proposed to be highly decoupled, modular, scalable and an integrated

4.4.1. Software and user acceptance testing

4.5. Adherence to standards